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Background: Bladder cancer (BCa) in patients suffering from neurogenic lower urinary tract dysfunction (NLUTD) is a significant concern due to its advanced stage at diagnosis and high mortality rate. Currently, there is a scarcity of specific guidelines for BCa screening in these patients. The development of urine biomarkers for BCa seems to be an attractive non-invasive method of screening or risk stratification in this patient population. DNA methylation is an epigenetic modification, resulting in the transcriptional silencing of tumor suppression genes, that is frequently detected in the urine of BCa patients. Objectives: We aimed to investigate DNA hypermethylation in five gene promoters, previously associated with BCa, in the urine of NLUTD patients, and in comparison with healthy controls. Design, setting and participants: This was a prospective case-control study that recruited neurourology outpatients from a public teaching hospital who had suffered from NLUTD for at least 5 years. They all underwent cystoscopy combined with biopsy for BCa screening following written informed consent. DNA was extracted and DNA methylation was assessed for the RASSF1, RARβ, DAPK, TERT and APC gene promoters via quantitative methylation-specific PCR in urine specimens from the patients and controls. Results: Forty-one patients of mixed NLUTD etiology and 35 controls were enrolled. DNA was detected in 36 patients' urine specimens and in those of 22 controls. In the urine specimens, DNA was hypermethylated in at least one of five gene promoters in 17/36 patients and in 3/22 controls (47.22% vs. 13.64%, respectively, p = 0.009). RASSF1 was hypermethylated in 10/17 (58.82%) specimens with detected methylation, APC in 7/17 (41.18%), DAPK in 4/17 (23.53%), RAR-β2 in 3/17 (17.56%) and TERT in none. According to a multivariate logistic regression analysis, NLUTD and male gender were significantly associated with hypermethylation (OR = 7.43, p = 0.007 and OR = 4.21; p = 0.04, respectively). In the tissue specimens, histology revealed TaLG BCa in two patients and urothelial squamous metaplasia in five patients. Chronic bladder inflammation was present in 35/41 bladder biopsies. Conclusions: DNA hypermethylation in a panel of five BCa-associated genes in the urine was significantly more frequent in NLUTD patients than in the controls. Our results warrant further evaluation in longitudinal studies assessing the clinical implications and possible associations between DNA hypermethylation, chronic inflammation and BCa in the NLUTD population.

Background: Black and Latino communities have been disproportionately impacted by coronavirus disease 2019 and we sought to understand perceptions and attitudes in four heavily impacted New Jersey counties to develop and evaluate engagement strategies to enhance access to testing., Objective: To establish a successful academic/community partnership team during a public health emergency by building upon longstanding relationships and using principles from community engaged research., Methods: We present a case study illustrating multiple levels of engagement, showing how we successfully aligned expectations, developed a commitment of cooperation, and implemented a research study, with community-based and health care organizations at the center of community engagement and recruitment., Lessons Learned: This paper describes successful approaches to relationship building including information sharing and feedback to foster reciprocity, diverse dissemination strategies to enhance engagement, and intergenerational interaction to ensure sustainability., Conclusions: This model demonstrates how academic/community partnerships can work together during public health emergencies to develop sustainable relationships.

At-home COVID-19 testing offers convenience and safety advantages. We evaluated at-home testing in Black and Latino communities through an intervention comparing community-based organization (CBO) and health care organization (HCO) outreach. From May through December 2021, 1100 participants were recruited, 94% through CBOs. The odds of COVID-19 test requests and completions were significantly higher in the HCO arm. The results showed disparities in test requests and completions related to age, race, language, insurance, comorbidities, and pandemic-related challenges. Despite the popularity of at-home testing, barriers exist in underresourced communities. ( Am J Public Health . 2022;112(S9):S918-S922. https://doi.org/10.2105/AJPH.2022.306989).

Purpose: Several studies have shown frequent changes in DNA methylation in bladder cancer (BCa), which vary among different geographical areas. The aim of this study is to examine the diagnostic accuracy of a panel of DNA methylation biomarkers in a Greek clinical setting contributing to the development of a universal panel of urine biomarkers., Materials and Methods: Individuals with primary BCa and control individuals matching the gender, age and smoking status of the cancer patients were recruited. DNA methylation was assessed for the gene promoters of RASSF1, RARB, DAPK, TERT and APC in urine samples collected by spontaneous urination using quantitative Methylation Specific PCR (qMSP). All genes had been previously separately associated with BCa., Results: Fifty patients and 35 healthy controls were recruited, with average age of 70.26 years and average smoking status of 44.78 pack-years. In the BCa group, DNA methylation was detected in 27 (61.4%) samples. RASSF1 was methylated in 52.2% of samples. Only 3 (13.6%) samples from the control group were methylated, all in the RASSF1 gene promoter. The specificity and sensitivity of this panel of genes to diagnose BCa was 86% and 61% respectively. The RASSF1 gene could diagnose BCa with specificity 86.4% and sensitivity 52.3%., Conclusion: Promoter DNA methylation of this panel of five genes could be further investigated as urine biomarker for the diagnosis of BCa. The RASSF1 could be a single candidate biomarker for predicting BCa patients versus controls. Studies are required in order to develop a geographically adjusted diagnostic biomarker for BCa.

Estimating the ambient concentration of nitrogen dioxide (NO 2 ) is challenging because NO 2 generated by local fossil fuel combustion varies greatly in concentration across space and time. This study demonstrates an integrated hybrid approach combining dispersion modeling and land use regression (LUR) to predict daily NO 2 concentrations at a high spatial resolution (e.g., 50 m) in the New York tri-state area. The daily concentration of traffic-related NO 2 was estimated at the Environmental Protection Agency's NO 2 monitoring sites in the study area for the years 2015-2017, using the Research LINE source (R-LINE) model with inputs of traffic data provided by the Highway Performance and Management System and meteorological data provided by the NOAA Integrated Surface Database. We used the R-LINE-predicted daily concentrations of NO 2 to build mixed-effects regression models, including additional variables representing land use features, geographic characteristics, weather, and other predictors. The mixed model was selected by the Elastic Net method. Each model's performance was evaluated using the out-of-sample coefficient of determination (R 2 ) and the square root of mean squared error (RMSE) from ten-fold cross-validation (CV). The mixed model showed a good prediction performance (CV R 2 : 0.75-0.79, RMSE: 3.9-4.0 ppb). R-LINE outputs improved the overall, spatial, and temporal CV R 2 by 10.0%, 18.9% and 7.7% respectively. Given the output of R-LINE is point-based and has a flexible spatial resolution, this hybrid approach allows prediction of daily NO 2 at an extremely high spatial resolution such as city blocks., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Aim: Lower urinary tract symptoms (LUTS) are a common urological referral, which sometimes can have a neurological basis in a patient with no formally diagnosed neurological disease ("occult neurology"). Early identification and specialist input is needed to avoid bad LUTS outcomes, and to initiate suitable neurological management., Methods: The International Continence Society established a neurological working group to consider: Which neurological conditions may include LUTS as an early feature? What diagnostic evaluations should be undertaken in the LUTS clinic? A shortlist of conditions was drawn up by expert consensus and discussed at the annual congress of the International Neurourology Society. A multidisciplinary working group then generated recommendations for identifying clinical features and management., Results: The relevant conditions are multiple sclerosis, multiple system atrophy, normal pressure hydrocephalus, early dementia, Parkinsonian syndromes (including early Parkinson's Disease and Multiple System Atrophy) and spinal cord disorders (including spina bifida occulta with tethered cord, and spinal stenosis). In LUTS clinics, the need is to identify additional atypical features; new onset severe LUTS (excluding infection), unusual aspects (eg, enuresis without chronic retention) or "suspicious" symptoms (eg, numbness, weakness, speech disturbance, gait disturbance, memory loss/cognitive impairment, and autonomic symptoms). Where occult neurology is suspected, healthcare professionals need to undertake early appropriate referral; central nervous system imaging booked from LUTS clinic is not recommended., Conclusions: Occult neurology is an uncommon underlying cause of LUTS, but it is essential to intervene promptly if suspected, and to establish suitable management pathways., (© 2020 The Authors. Neurourology and Urodynamics published by Wiley Periodicals LLC.)

DNA methylation has emerged as a promising target linking environmental exposures and cancer. The World Trade Center (WTC) responders sustained exposures to potential carcinogens, resulting in an increased risk of cancer. Previous studies of cancer risk in WTC-exposed responders were limited by the deficiency in quantitative and individual information on exposure to carcinogens. The current study introduces a new exposure-ranking index (ERI) for estimating cancer-related acute and chronic exposures, which aimed to improve the ability of future analyses to estimate cancer risk. An epigenome-wide association study based on DNA methylation and a weighted gene co-expression network analysis were carried out to identify cytosine-phosphate-guanosine (CpG) sites, modules of correlated CpG sites, and biological pathways associated with the new ERI. Methylation was profiled on blood samples using Illumina 450K Beadchip. No significant epigenome-wide association was found for ERI at a false discovery rate of 0.05. Several cancer-related pathways emerged in pathway analyses for the top ranking genes from epigenome-wide association study as well as enriched module from the weighted gene co-expression network analysis. The current study was the first DNA methylation study that aimed to identify methylation signature for cancer-related exposure in the WTC population. No CpG sites survived multiple testings adjustment. However, enriched gene sets involved in cancer, were identified in both acute and chronic ERIs, supporting the view that multiple genes play a role in this complex exposure.

Objective: Functional electrical stimulation is used to improve walking speed and reduces falls in people with upper motor neurone foot-drop. Following anecdotal observations of changes in bladder symptoms, an observational study was performed to explore this association further., Design: A total of 47 consecutive patients attending for setup with functional electrical stimulation during a six-month period were asked to complete a questionnaire assessing bladder symptoms (ICIQ-OAB (International Consultation on Incontinence Questionnaire Overactive Bladder)) at baseline and three  months during routine appointments., Subjects: In all, 35 (75%) had multiple sclerosis and the other 12 subjects had a total of 9 diagnoses including 3 with stroke. Other conditions included cerebral palsy, motor neurone disease, hereditary spastic paraparesis, meningioma and spinocerebellar ataxias., Results: Improvement in overactive bladder symptoms was not significant in the whole cohort, however, was significant in patients with multiple sclerosis ( n  =  35; mean change in ICIQ-OAB score 1.0, P  =  0.043). Specifically, significant improvements were seen in urgency and urge incontinence in multiple sclerosis patients. There was a significant negative correlation of moderate strength within the multiple sclerosis cohort between baseline walking speed and subsequent change in ICIQ-OAB score (correlation coefficient of r  =  -0.40, P  =  0.046). Thus, greater changes in bladder symptoms were seen with lower baseline walking speeds., Conclusion: The results of this exploratory study suggest that functional electrical stimulation use does improve overactive bladder symptoms in people with multiple sclerosis. Further exploration is needed to study this association and explore whether the mechanism is similar to that of percutaneous tibial nerve stimulation, a recognized treatment for the overactive bladder.

Purpose of Review: This review aims to analyze and discuss all recently published articles associated with neurogenic voiding discussion providing readers with the most updated knowledge and trigger for further research., Recent Findings: They include the proposal of a novel classification system for the pathophysiology of neurogenic lower urinary tract dysfunction (NLUTD) which combines neurological defect in a distinct anatomic location, and data on bowel dysfunction, autonomic dysreflexia and urine biomarkers; review of patient-reported outcome measures in NLUTD; review of the criteria for the diagnosis of clinically significant urinary infections; novel research findings on the pathophysiology of NLUTD; and review of data on minimally and more invasive treatments., Summary: Despite the extended evidence base on NLUTD, there is a paucity of high-quality new research concerning voiding dysfunction as opposed to storage problems. The update aims to inform clinicians about new developments in clinical practice, as well as ignite discussion for further clinical and basic research in the aforementioned areas of NLUTD.

To investigate whether the X-ray unit type used for interventional endoscopic retrograde cholangiopancreatography (ERCP) procedures may affect patient radiation doses. A total of 471 ERCP procedures performed in 4 hospitals with 4 types of X-ray units were studied. Kerma-area product (KAP), fluoroscopy time (T) and total number of radiographs acquired (F) were recorded. KAP, T and F values exhibited a great variation, ranging from 0.1 to 130.2 Gy cm 2 (mean 16 Gy cm 2 ), 0.13 to 33.7 min (mean 5.4 min) and 0 to 26 radiographs (mean 3.5), respectively. The respective mean values for the four types of X-ray units that were investigated were as follows: KAP: 17.4, 12.5, 5.6 and 36.3 Gy cm 2 , T: 4.7, 5.2, 3.8 and 11.5 min and F: 1.7, 7.4, 1.9 and 4.6 radiographs. The type of the X-ray unit seems to significantly affect patient radiation dose, with the C-arm delivering the lowest and the angiography unit the highest patient doses., (© The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)

The main objective of this study was to determine the preliminary Diagnostic Reference Levels (DRLs) in terms of Kerma Area Product (KAP) and fluoroscopy time (Tf) during Endoscopic Retrograde Cholangio-Pancreatography (ERCP) procedures. Additionally, an investigation was conducted to explore the statistical relation between KAP and Tf. Data from a set of 200 randomly selected patients treated in 4 large hospitals in Greece (50 patients per hospital) were analyzed in order to obtain preliminary DRLs for KAP and Tf during therapeutic ERCP procedures. Non-parametric statistic tests were performed in order to determine a statistically significant relation between KAP and Tf. The resulting third quartiles for KAP and Tf for hospitals (A, B, C and D) were found as followed: KAPA=10.7Gycm(2), TfA=4.9min; KAPB=7.5Gycm(2), TfB=5.0min; KAPC=19.0Gycm(2), TfC=7.3min; KAPD=52.4Gycm(2), TfD=15.8min. The third quartiles, calculated for the total 200 cases sample, are: KAP=18.8Gycm(2) and Tf=8.2min. For 3 out of 4 hospitals and for the total sample, p-values of statistical indices (correlation of KAP and Tf) are less than 0.001, while for the Hospital A p-values are ranging from 0.07 to 0.08. Using curve fitting, we finally determine that the relation of Tf and KAP is deriving from a power equation (KAP=Tf(1.282)) with R(2)=0.85. The suggested Preliminary DRLs (deriving from the third quartiles of the total sample) for Greece are: KAP=19Gycm(2) and Tf=8min, while the relation between KAP and Tf is efficiently described by a power equation., (Copyright © 2016 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.)

Increasing use of engineered nanomaterials (ENMs) in consumer products may result in widespread human inhalation exposures. Due to their high surface area per unit mass, inhaled ENMs interact with multiple components of the pulmonary system, and these interactions affect their ultimate fate in the body. Modeling of ENM transport and clearance in vivo has traditionally treated tissues as well-mixed compartments, without consideration of nanoscale interaction and transformation mechanisms. ENM agglomeration, dissolution and transport, along with adsorption of biomolecules, such as surfactant lipids and proteins, cause irreversible changes to ENM morphology and surface properties. The model presented in this article quantifies ENM transformation and transport in the alveolar air to liquid interface and estimates eventual alveolar cell dosimetry. This formulation brings together established concepts from colloidal and surface science, physics, and biochemistry to provide a stochastic framework capable of capturing essential in vivo processes in the pulmonary alveolar lining layer. The model has been implemented for in vitro solutions with parameters estimated from relevant published in vitro measurements and has been extended here to in vivo systems simulating human inhalation exposures. Applications are presented for four different ENMs, and relevant kinetic rates are estimated, demonstrating an approach for improving human in vivo pulmonary dosimetry., Competing Interests: The authors declare no conflicts of interest.

We studied the processes of inhibition and facilitation in the dentate gyrus (DG) and the CA3 field by examining the effects of paired-pulse stimulation on the evoked population spike (PS) in dorsal (DH) and ventral (VH) hippocampal slices from the adult rat. The antidromic-orthodromic (A-O) and the orthodromic-orthodromic (O-O) paired-pulse stimulation protocols were used at varying inter-pulse intervals (IPI). In the DG, the A-O stimulation produced an early depression of PS lasting 30-40ms which was significantly stronger in the VH compared with DH. The O-O stimulation produced a biphasic pattern of effects, in both dorsal and ventral DG, consisting of an early depression of PS followed by facilitation at relatively longer intervals. In the DH but not the VH the phase of facilitation was followed by a late depression of PS (>200ms). In the CA3 field both A-O and O-O stimulation had a biphasic effect consisting of an early phase of strong depression of similar strength in DH and VH. The depression was followed by a phase of facilitation which was more pronounced with O-O stimulation. The facilitation observed with the O-O stimulation was much stronger in DH than VH and in DH only it was significantly reduced by the antagonist of GABAB receptors CGP52432. Furthermore, the facilitation was insensitive to changes in [Ca(2+)]o in both hippocampal poles. These findings suggest that the dorsal compared with ventral DG is more amenable to fast-frequency input but filters out slow-frequency inputs more reliably while the gating and amplification of the excitatory input in the CA3 circuitry is more prominent in DH than in VH., (Copyright © 2015 Elsevier B.V. All rights reserved.)

Many diseases are linked with climate trends and variations. In particular, climate change is expected to alter the spatiotemporal dynamics of allergenic airborne pollen and potentially increase occurrence of allergic airway disease. Understanding the spatiotemporal patterns of changes in pollen season timing and levels is thus important in assessing climate impacts on aerobiology and allergy caused by allergenic airborne pollen. Here, we describe the spatiotemporal patterns of changes in the seasonal timing and levels of allergenic airborne pollen for multiple taxa in different climate regions at a continental scale. The allergenic pollen seasons of representative trees, weeds and grass during the past decade (2001-2010) across the contiguous United States have been observed to start 3.0 [95% Confidence Interval (CI), 1.1-4.9] days earlier on average than in the 1990s (1994-2000). The average peak value and annual total of daily counted airborne pollen have increased by 42.4% (95% CI, 21.9-62.9%) and 46.0% (95% CI, 21.5-70.5%), respectively. Changes of pollen season timing and airborne levels depend on latitude, and are associated with changes of growing degree days, frost free days, and precipitation. These changes are likely due to recent climate change and particularly the enhanced warming and precipitation at higher latitudes in the contiguous United States., (© 2014 John Wiley & Sons Ltd.)

Allergenic pollen is one of the main triggers of Allergic Airway Disease (AAD) affecting 5% to 30% of the population in industrialized countries. A modeling framework has been developed using correlation and collinearity analyses, simulated annealing, and stepwise regression based on nationwide observations of airborne pollen counts and climatic factors to predict the onsets and durations of allergenic pollen seasons of representative trees, weeds and grass in the contiguous United States. Main factors considered are monthly, seasonal and annual mean temperatures and accumulative precipitations, latitude, elevation, Growing Degree Day (GDD), Frost Free Day (FFD), Start Date (SD) and Season Length (SL) in the previous year. The estimated mean SD and SL for birch ( Betula ), oak ( Quercus ), ragweed ( Ambrosia ), mugwort ( Artemisia ) and grass ( Poaceae ) pollen season in 1994-2010 are mostly within 0 to 6 days of the corresponding observations for the majority of the National Allergy Bureau (NAB) monitoring stations across the contiguous US. The simulated spatially resolved maps for onset and duration of allergenic pollen season in the contiguous US are consistent with the long term observations.

Aircraft cabin disinsection is required by some countries to kill insects that may pose risks to public health and native ecological systems. A probabilistic model has been developed by considering the microenvironmental dynamics of the pesticide in conjunction with the activity patterns of flight attendants, to assess their exposures and risks to pesticide in disinsected aircraft cabins under three scenarios of pesticide application. Main processes considered in the model are microenvironmental transport and deposition, volatilization, and transfer of pesticide when passengers and flight attendants come in contact with the cabin surfaces. The simulated pesticide airborne mass concentration and surface mass loadings captured measured ranges reported in the literature. The medians (means ± standard devitions) of daily total exposure intakes were 0.24 (3.8 ± 10.0), 1.4 (4.2 ± 5.7), and 0.15 (2.1 ± 3.2) μg day(-1) kg(-1) of body weight for scenarios of residual application, preflight, and top-of-descent spraying, respectively. Exposure estimates were sensitive to parameters corresponding to pesticide deposition, body surface area and weight, surface-to-body transfer efficiencies, and efficiency of adherence to skin. Preflight spray posed 2.0 and 3.1 times higher pesticide exposure risk levels for flight attendants in disinsected aircraft cabins than top-of-descent spray and residual application, respectively.

A Bayesian framework is presented for modeling Effects of climate change on pollen indices such as annual birch pollen count, maximum daily birch pollen count, start date of birch pollen season and the date of maximum daily birch pollen count. Annual mean CO 2 concentration, mean spring temperature and the corresponding pollen index of prior year were found to be statistically significant accounting for Effects of climate change on four pollen indices. Results suggest that annual productions and peak values from 2020 to 2100 under different scenarios will be 1.3-8.0 and 1.1-7.3 times higher respectively than the mean values for 2000, and start and peak dates will occur around two to four weeks earlier. These results have been partly confirmed by the available historical data. As a demonstration, the emission profiles in future years were generated by incorporating the predicted pollen indices into an existing emission model.

Personal exposures and ambient concentrations of air toxics were characterized in a pollution "hot spot" and an urban reference site, both in Camden, New Jersey. The hot spot was the city's Waterfront South neighborhood; the reference site was a neighborhood, about 1 km to the east, around the intersection of Copewood and Davis streets. Using personal exposure measurements, residential ambient air measurements, statistical analyses, and exposure modeling, we examined the impact of local industrial and mobile pollution sources, particularly diesel trucks, on personal exposures and ambient concentrations in the two neighborhoods. Presented in the report are details of our study design, sample and data collection methods, data- and model-analysis approaches, and results and key findings of the study. In summary, 107 participants were recruited from nonsmoking households, including 54 from Waterfront South and 53 from the Copewood-Davis area. Personal air samples were collected for 24 hr and measured for 32 target compounds--11 volatile organic compounds (VOCs*), four aldehydes, 16 polycyclic aromatic hydrocarbons (PAHs), and particulate matter (PM) with an aerodynamic diameter < or = 2.5 microm (PM2.5). Simultaneously with the personal monitoring, ambient concentrations of the target compounds were measured at two fixed monitoring sites, one each in the Waterfront South and Copewood-Davis neighborhoods. To understand the potential impact of local sources of air toxics on personal exposures caused by temporal (weekdays versus weekend days) and seasonal (summer versus winter) variations in source intensities of the air toxics, four measurements were made of each subject, two in summer and two in winter. Within each season, one measurement was made on a weekday and the other on a weekend day. A baseline questionnaire and a time diary with an activity questionnaire were administered to each participant in order to obtain information that could be used to understand personal exposure to specific air toxics measured during each sampling period. Given the number of emission sources of air toxics in Waterfront South, a spatial variation study consisting of three saturation-sampling campaigns was conducted to characterize the spatial distribution of VOCs and aldehydes in the two neighborhoods. Passive samplers were used to collect VOC and aldehyde samples for 24- and 48-hr sampling periods simultaneously at 22 and 16 grid-based sampling sites in Waterfront South and Copewood-Davis, respectively. Results showed that measured ambient concentrations of some target pollutants (mean +/- standard deviation [SD]), such as PM2.5 (31.3 +/- 12.5 microg/m3), toluene (4.24 +/- 5.23 microg/m3), and benzo[a]pyrene (0.36 +/- 0.45 ng/m3), were significantly higher (P < 0.05) in Waterfront South than in Copewood-Davis, where the concentrations of PM2.5, toluene, and benzo[a]pyrene were 25.3 +/- 11.9 microg/m3, 2.46 +/- 3.19 microg/m3, and 0.21 +/- 0.26 ng/m3, respectively. High concentrations of specific air toxics, such as 60 microg/m3 for toluene and 159 microg/m3 for methyl tert-butyl ether (MTBE), were also found in areas close to local stationary sources in Waterfront South during the saturation-sampling campaigns. Greater spatial variation in benzene, toluene, ethylbenzene, and xylenes (known collectively as BTEX) as well as of MTBE was observed in Waterfront South than in Copewood-Davis during days with low wind speed. These observations indicated the significant impact of local emission sources of these pollutants and possibly of other pollutants emitted by individual source types on air pollution in Waterfront South. (Waterfront South is a known hot spot for these pollutants.) There were no significant differences between Waterfront South and Copewood-Davis in mean concentrations of benzene or MTBE, although some stationary sources of the two compounds have been reported in Waterfront South. Further, a good correlation (R > 0.6) was found between benzene and MTBE in both locations. These results suggest that automobile exhausts were the main contributors to benzene and MTBE air pollution in both neighborhoods. Formaldehyde and acetaldehyde concentrations were found to be high in both neighborhoods. Mean (+/- SD) concentrations of formaldehyde were 20.2 +/- 19.5 microg/m3 in Waterfront South and 24.8 +/- 20.8 microg/m3 in Copewood-Davis. A similar trend was observed for the two compounds during the saturation-sampling campaigns. The results indicate that mobile sources (i.e., diesel trucks) had a large impact on formaldehyde and acetaldehyde concentrations in both neighborhoods and that both are aldehyde hot spots. The study also showed that PM2.5, aldehydes, BTEX, and MTBE concentrations in both Waterfront South and Copewood-Davis were higher than ambient background concentrations in New Jersey and than national average concentrations, indicating that both neighborhoods are in fact hot spots for these pollutants. Higher concentrations were observed on weekdays than on weekend days for several compounds, including toluene, ethylbenzene, and xylenes (known collectively as TEX) as well as PAHs and PM2.5. These observations showed the impact on ambient air pollution of higher traffic volumes and more active industrial and commercial operations in the study areas on weekdays. Seasonal variations differed by species. Concentrations of TEX, for example, were found to be higher in winter than in summer in both locations, possibly because of higher emission rates from automobiles and reduced photochemical reactivity in winter. In contrast, concentrations of MTBE were found to be significantly higher in summer than in winter in both locations, possibly because of higher evaporation rates from gasoline in summer. Similarly, concentrations of heavier PAHs, such as benzo[a]pyrene, were found to be higher in winter in both locations, possibly because of higher emission rates from mobile sources, the use of home heating, and the reduced photochemical reactivity of benzo[a]pyrene in winter. In contrast, concentrations of lighter PAHs were found to be higher in summer in both locations, possibly because of volatilization of these compounds from various surfaces in summer. In addition, higher concentrations of formaldehyde were observed in summer than in winter, possibly because of significant contributions from photochemical reactions to formaldehyde air pollution in summer. Personal concentrations of toluene (25.4 +/- 13.5 microg/m3) and acrolein (1.78 +/- 3.7 microg/m3) in Waterfront South were found to be higher than those in the Copewood-Davis neighborhood (13.1 +/- 15.3 microg/m3 for toluene and 1.27 +/- 2.36 microg/m3 for acrolein). However, personal concentrations for most of the other compounds measured in Waterfront South were found to be similar to or lower than those than in Copewood-Davis. (For example, mean +/- SD concentrations were 4.58 +/- 17.3 microg/m3 for benzene, 4.06 +/- 5.32 microg/m3 for MTBE, 16.8 +/- 15.5 microg/m3 for formaldehyde, and 0.40 +/- 0.94 ng/m3 for benzo[a]pyrene in Waterfront South and 9.19 +/- 34.0 microg/m3 for benzene, 6.22 +/- 19.0 microg/m3 for MTBE, 16.0 +/- 16.7 microg/m3 for formaldehyde, and 0.42 +/- 1.08 ng/m3 for benzo[a]pyrene in Copewood-Davis.) This was probably because many of the target compounds had both outdoor and indoor sources. The higher personal concentrations of these compounds in Copewood-Davis might have resulted in part from higher exposure to environmental tobacco smoke (ETS) of subjects from Copewood-Davis. The Spearman correlation coefficient (R) was found to be high for pollutants with significant outdoor sources. The R's for MTBE and carbon tetrachloride, for example, were > 0.65 in both Waterfront South and Copewood-Davis. The R's were moderate or low (0.3-0.6) for compounds with both outdoor and indoor sources, such as BTEX and formaldehyde. A weaker association (R < 0.5) was found for compounds with significant indoor sources, such as BTEX, formaldehyde, PAHs, and PM2.5. The correlations between personal and ambient concentrations of MTBE and BTEX were found to be stronger in Waterfront South than in Copewood-Davis, reflecting the significant impact of local air pollution sources on personal exposure to these pollutants in Waterfront South. Emission-based ambient concentrations of benzene, toluene, and formaldehyde and contributions of ambient exposure to personal concentrations of these three compounds were modeled using atmospheric dispersion modeling and Individual Based Exposure Modeling (IBEM) software, respectively, which were coupled for analysis in the Modeling Environment for Total Risk (MENTOR) system. The compounds were associated with the three types of dominant sources in the two neighborhoods: industrial sources (toluene), exhaust from gasoline-powered motor vehicles (benzene), and exhaust from diesel-powered motor vehicles (formaldehyde). Subsequently, both the calculated and measured ambient concentrations of each of the three compounds were separately combined with the time diaries and activity questionnaires completed by the subjects as inputs to IBEM-MENTOR for estimating personal exposures from ambient sources. Modeled ambient concentrations of benzene and toluene were generally in agreement with the measured ambient concentrations within a factor of two, but the values were underestimated at the high-end percentiles. The major local (neighborhood) contributors to ambient benzene concentrations were from mobile sources in the study areas; both mobile and stationary (point and area) sources contributed to the ambient toluene concentrations. This finding can be used as guidance for developing better emission inventories to characterize, through modeling, the ambient concentrations of air toxics in the study areas. (ABSTRACT TRUNCATED)

Allergic airway diseases represent a complex health problem which can be exacerbated by the synergistic action of pollen particles and air pollutants such as ozone. Understanding human exposures to aeroallergens requires accurate estimates of the spatial distribution of airborne pollen levels as well as of various air pollutants at different times. However, currently there are no established methods for estimating allergenic pollen emissions and concentrations over large geographic areas such as the United States. A mechanistic modeling system for describing pollen emissions and transport over extensive domains has been developed by adapting components of existing regional scale air quality models and vegetation databases. First, components of the Biogenic Emissions Inventory System (BEIS) were adapted to predict pollen emission patterns. Subsequently, the transport module of the Community Multiscale Air Quality (CMAQ) modeling system was modified to incorporate description of pollen transport. The combined model, CMAQ-pollen, allows for simultaneous prediction of multiple air pollutants and pollen levels in a single model simulation, and uses consistent assumptions related to the transport of multiple chemicals and pollen species. Application case studies for evaluating the combined modeling system included the simulation of birch and ragweed pollen levels for the year 2002, during their corresponding peak pollination periods (April for birch and September for ragweed). The model simulations were driven by previously evaluated meteorological model outputs and emissions inventories for the eastern United States for the simulation period. A semi-quantitative evaluation of CMAQ-pollen was performed using tree and ragweed pollen counts in Newark, NJ for the same time periods. The peak birch pollen concentrations were predicted to occur within two days of the peak measurements, while the temporal patterns closely followed the measured profiles of overall tree pollen. For the case of ragweed pollen, the model was able to capture the patterns observed during September 2002, but did not predict an early peak; this can be associated with a wider species pollination window and inadequate spatial information in current land cover databases. An additional sensitivity simulation was performed to comparatively evaluate the dispersion patterns predicted by CMAQ-pollen with those predicted by the Hybrid Single-Particle Lagrangian Integrated Trajectory (HYSPLIT) model, which is used extensively in aerobiological studies. The CMAQ estimated concentration plumes matched the equivalent pollen scenario modeled with HYSPLIT. The novel pollen modeling approach presented here allows simultaneous estimation of multiple airborne allergens and other air pollutants, and is being developed as a central component of an integrated population exposure modeling system, the Modeling Environment for Total Risk studies (MENTOR) for multiple, co-occurring contaminants that include aeroallergens and irritants.

Background: Dietary exposure from food to toxic inorganic arsenic (iAs) in the general U.S. population has not been well studied., Objectives: The goal of this research was to quantify dietary As exposure and analyze the major contributors to total As (tAs) and iAs. Another objective was to compare model predictions with observed data., Methods: Probabilistic exposure modeling for dietary As was conducted with the Stochastic Human Exposure and Dose Simulation Dietary (SHEDS-Dietary) model, based on data from the National Health and Nutrition Examination Survey. The dose modeling was conducted by combining the SHEDS-Dietary model with the MENTOR-3P (Modeling ENvironment for TOtal Risk with Physiologically Based Pharmacokinetic Modeling for Populations) system. Model evaluation was conducted via comparing exposure and dose-modeling predictions against duplicate diet data and biomarker measurements, respectively, for the same individuals., Results: The mean modeled tAs exposure from food is 0.38 microg/kg/day, which is approximately 14 times higher than the mean As exposures from the drinking water. The mean iAs exposure from food is 0.05 microg/kg/day (1.96 microg/day), which is approximately two times higher than the mean iAs exposures from the drinking water. The modeled exposure and dose estimates matched well with the duplicate diet data and measured As biomarkers. The major food contributors to iAs exposure were the following: vegetables (24%); fruit juices and fruits (18%); rice (17%); beer and wine (12%); and flour, corn, and wheat (11%). Approximately 10% of tAs exposure from foods is the toxic iAs form., Conclusions: The general U.S. population may be exposed to tAs and iAs more from eating some foods than from drinking water. In addition, this model evaluation effort provides more confidence in the exposure assessment tools used.

Researchers have reported adverse health effects among rescue/recovery workers and people living near the World Trade Center on September 11, 2001. The authors investigated the occurrence of respiratory symptoms among persons living outside of Lower Manhattan in areas affected by the World Trade Center particulate matter plume. Using a novel atmospheric dispersion model, they estimated relative cumulative plume intensity in areas surrounding the World Trade Center site over a 5-day period following the collapse of the buildings. Using data from a telephone survey of residents (n = 2,755) conducted approximately 6 months after the event, the authors evaluated associations between the estimated plume intensities at individual residence locations and self-reported respiratory symptoms among nonasthmatics, as well as symptoms and nonroutine care among asthmatics. Comparing persons at or above the 75th percentile of cumulative plume intensity with those below it, there was no statistically significant difference in self-reported new-onset wheezing/cough after September 11 (16.1% vs. 13.3%; adjusted odds ratio = 1.0, 95% confidence interval: 0.7, 1.7) and no worsening of asthma from before September 11 to the 4 weeks prior to the survey (13.9% vs. 16.6%; odds ratio = 1.0, 95% confidence interval: 0.3, 2.8). These results suggest that the plume was not strongly associated with respiratory symptoms outside of Lower Manhattan, within the limitations of this retrospective study.

The spatial variations of volatile organic compounds (VOCs) were characterized in the Village of Waterfront South neighborhood (WFS), a "hot spot" for air toxics in Camden, NJ. This was accomplished by conducting "spatial saturation sampling" for 11 VOCs using 3500 OVM passive samplers at 22 sites in WFS and 16 sites in Copewood/Davis Streets (CDS) neighborhood, an urban reference area located ∼1000 m east of the WFS. Sampling durations were 24 and 48 h. For all 3 sampling campaigns (2 in summer and 1 in winter), the spatial variations and median concentrations of toluene, ethylbenzene, and xylenes (TEX) were found significantly higher (p < 0.05) in WFS than in CDS, where the spatial distributions of these compounds were relatively uniform. The highest concentrations of methyl tert-butyl ether (MTBE) (maximum of 159 μg m(-3)) were always found at one site close to a car scrapping facility in WFS during each sampling campaign. The spatial variation of benzene in WFS was found to be marginally higher (p = 0.057) than in CDS during one sampling campaign, but similar in the other two sampling periods. The results obtained from the analyses of correlation among all species and the proximity of sampling site to source indicated that local stationary sources in WFS have significant impact on MTBE and BTEX air pollution in WFS, and both mobile sources and some of the stationary sources in WFS contributed to the ambient levels of these species measured in CDS. The homogenous spatial distributions (%RSD < 24%) and low concentrations of chloroform (0.02-0.23 μg m(-3)) and carbon tetrachloride (0.45-0.51 μg m(-3)) indicated no significant local sources in the study areas. Further, results showed that the sampling at the fixed monitoring site may under- or over-estimate air pollutant levels in a "hot spot" area, suggesting that the "spatial saturation sampling" is necessary for conducting accurate assessment of air pollution and personal exposure in a community with a high density of sources.

A modular system for source-to-dose-to-effect modeling analysis has been developed based on the modeling environment for total risk studies (MENTOR),((1)) and applied to study the impacts of hypothetical atmospheric releases of anthrax spores. The system, MENTOR-2E (MENTOR for Emergency Events), provides mechanistically consistent analysis of inhalation exposures for various release scenarios, while allowing consideration of specific susceptible subpopulations (such as the elderly) at the resolution of individual census tracts. The MENTOR-2E application presented here includes atmospheric dispersion modeling, statistically representative samples of individuals along with corresponding activity patterns, and population-based dosimetry modeling that accounts for activity and physiological variability. Two hypothetical release scenarios were simulated: a 100 g release of weaponized B. anthracis over a period of (a) one hour and (b) 10 hours, and the impact of these releases on population in the State of New Jersey was studied. Results were compared with those from simplified modeling of population dynamics (location, activities, etc.), and atmospheric dispersion of anthrax spores. The comparisons showed that in the two release scenarios simulated, each major approximation resulted in an overestimation of the number of probable infections by a factor of 5 to 10; these overestimations can have significant public health implications when preparing for and responding effectively to an actual release. This is in addition to uncertainties in dose-response modeling, which result in an additional factor of 5 to 10 variation in estimated casualties. The MENTOR-2E system has been developed in a modular fashion so that improvements in individual modules can be readily made without impacting the other modules, and provides a first step toward the development of models that can be used in supporting real-time decision making.

The positive modulation of the GABA(A) receptor (GABA(A)R) is presumably one of the main mechanisms by which several sedatives mediate their actions in the central nervous system. This modulation appears to depend on the presence of alpha and beta GABA(A)R subunits, whose distinct expression in dorsal and ventral hippocampus has been recently shown. Using population spike recordings from the CA1 area of dorsal (DHS) and ventral (VHS) hippocampal slices we compared the effects of seven sedative/anesthetic drugs (diazepam, midazolam, phenobarbital, propofol, pentobarbital, thiopental and alfaxalone) on the GABAergic recurrent inhibition (RI) between the two hippocampal poles. The strength and duration of RI was quantified by measuring an antidromic stimulation-induced suppression of the orthodromic population spike at varying inter-pulse intervals. All drugs enhanced RI in both DHS and VHS but high concentrations of barbiturates and alfaxalone prolonged RI considerably more compared to benzodiazepines or low doses of barbiturates and propofol. Furthermore, the drug-induced prolongation of RI was significantly greater in DHS than in VHS. Thus, RI was enhanced by thiopental (50 microM), alfaxalone (2.5 microM) and pentobarbital (50 microM) up to 150 ms, 150 ms and 270 ms respectively in DHS, and up to 70 ms, 100 ms and 150 ms respectively in VHS. In addition, under GABA(B) receptor blockade, thiopental (100 microM) and alfaxalone (10 microM) prolonged GABA(A)R-mediated RI significantly more in DH (up to 900 ms) than in VH (up to 430 ms and 600 ms respectively). This finding provides support to the notion of diversification of intrinsic organization along the septotemporal axis of the hippocampus. Finally, an interesting link was revealed between the magnitude of drug-induced enhancement of RI and the reported sedative potency of the drugs used, suggesting that deep sedation and anesthesia may involve prolongation of GABAergic inhibition.

A personal exposure study was conducted in New York City as part of the Urban Dispersion Program (UDP). It examined the contact of individuals with four harmless perflourocarbon tracers (PFT) released in Midtown Manhattan with approval by city agencies at separate locations, during two types of experiments, completed during each release period. Two continuous 1 h release periods separated by a 1.5 h ventilation time were completed on 3 October 2005. Stationary site and personal exposure measurements were taken during each period, and the first half hour after the release ended. Two types of scripted exposure activities are reported: Outdoor Source Scale, and Outdoor Neighborhood Scale; requiring 1- and 10-min duration samples, respectively. The results showed that exposures were influenced by the surface winds, the urban terrain, and the movements of people and vehicles typical in urban centers. The source scale exposure data indicated that local conditions significantly affected the distribution of each tracer, and consequently the exposures. The highest PFT exposures resulted from interaction of the scripted activities with local surface conditions. The range measured for 1- min exposures were large with measured values exceeding 5000 ppqv (parts per quadrillion by volume). The neighborhood scale measurements quantified exposures at distances up to seven blocks away from the release points. Generally, but not always, the PFT levels returned quickly to zero indicating that after cessation of the emissions the concentrations decrease rapidly, and reduce the intensity of local exposures. The near source and neighborhood personal exposure route results provided information to establish a baseline for determining how a release could affect both the general public and emergency responders, and evaluate the adequacy of re-entry or exit strategies from a local area. Finally, the data also show that local characteristics can produce "hot spots".

Hippocampal functions appear to be segregated along the dorso-ventral axis of the structure. Differences at the cellular and local neuronal network level may be involved in this functional segregation. In this study the characteristics of CA1 recurrent inhibition (RI) were measured and compared between dorsal (DH, n = 95) and ventral (VH, n = 60) hippocampal slices, using recordings of suprathreshold field potentials. RI strength was estimated as the percentile decrease of the population spike (PS) amplitude evoked with an orthodromic stimulus (at the Schaffer collaterals) when preceded by an antidromic stimulus (at the alveus). Varying the interpulse interval (IPI) between the two stimuli, we estimated RI duration. Alvear stimulation produced significant PS suppression in both VH and DH at every IPI tested, from 10 to 270 ms. Moreover, gradually more oblique DH (but not VH) slices displayed increasing RI, which at IPIs < or = 125 ms was reversibly abolished by the GABAA receptor antagonist picrotoxin (10 microM). The GABAA-mediated RI, measured under the blockade of GABAB receptors, was weaker, decayed faster and lasted less in VH compared to DH slices, regardless of the slice orientation. Specifically, in VH compared to DH, the PS suppression at 20 ms was 34.4 +/- 4.5% versus 69.9 +/- 6.5% (P < 0.001), the time constant of RI decay was 29 +/- 2.4 versus 87.5 +/- 13.6 ms (P < 0.01) and the duration was 50 versus 125 ms (P < 0.001). Thus, GABAA-mediated RI may control the CA1 excitatory output less effectively in VH compared to DH. The observed dorso-ventral differences in RI contribute to the longitudinal diversification of the structure and may underlie to some extent the region-specificity of hippocampal functions.

The attack on the World Trade Center (WTC) resulted in a new era of awareness on terrorism in the United States and the issues surrounding the potential for acute and/or long-term health outcomes caused by personal exposures to toxicants released during a terrorist event or an accident. The aftermath of the collapse yielded a situation usually not encountered in environmental health science: a large population's exposure to a previously uncharacterized complex mixture of airborne gases and particles, and re-suspendable particles (>2.5 microm in diameter). This led to a series of rapidly changing potential and actual exposure categories, both in space and time that were associated with the complex mixture of heterogeneous composition and character; e.g., very large particles mixed with much smaller amounts of fine particles, and gases released by uncontrolled combustion. The four categories of outdoor exposure that were encountered will be discussed over the period from September 11 until the fires ended on December 20, 2001. Further, the complex issue of indoor exposure to deposited dust will be highlighted from the beginning through the residual exposure issues being examined today (Category 5 period). The strength of the information on the initial WTC dust and smoke, and the smoke plumes from the fires and the continuing (permanent) gaps in our knowledge within the exposure sciences will be discussed, as well as our attempt to reconstruct exposure for various segments of the population in southern Manhattan and the surrounding areas. This all will be tied to lessons that must be considered in response to future events, natural or otherwise.

The comprehensive individual field-measurements on non-dietary exposure collected in the Children's-Post-Pesticide-Application-Exposure-Study (CPPAES) were used within MENTOR/SHEDS-Pesticides, a physically based stochastic human exposure and dose model. In this application, however, the model was run deterministically. The MENTOR/SHEDS-Pesticides employed the CPPAES as input variables to simulate the exposure and the dose profiles for seven children over a 2-week post-application period following a routine residential and professional indoor crack-and-crevice chlorpyrifos application. The input variables were obtained from a personal activity diary, microenvironmental measurements and personal biomonitoring data obtained from CPPAES samples collected from the individual children and in their homes. Simulation results were compared with CPPAES field measured values obtained from the children's homes to assess the utility of the different microenvironmental data collected in CPPAES, i.e. indicator toys and wipe samplers to estimate aggregate exposures that can be result from one or more exposure pathways and routes. The final analyses of the database involved comparisons of the actual data obtained from the individual biomarker samples of a urinary metabolite of chlorpyrifos (TCPy) and the values predicted by MENTOR/SHEDS-Pesticides using the CPPAES-derived variables. Because duplicate diet samples were not part of the CPPAES study design, SHEDs-Pesticides simulated dose profiles did not account for the dietary route. The research provided more confidence in the types of data that can be used in the inhalation and dermal contact modules of MENTOR/SHEDS-Pesticides to predict the pesticide dose received by a child. It was determined that we still need additional understanding about: (1) the types of activities and durations of activities that result in non-dietary ingestion of pesticides and (2) the influence of dietary exposures on the levels of TCPy found in the urine.

We have characterized environmental exposures among 187 women who were pregnant, were at or near the World Trade Center (WTC) on or soon after 11 September 2001, and are enrolled in a prospective cohort study of health effects. Exposures were assessed by estimating time spent in five zones around the WTC and by developing an exposure index (EI) based on plume reconstruction modeling. The daily reconstructed dust levels were correlated with levels of particulate matter < or = 2.5 microm in aerodynamic diameter (PM2.5; r = 0.68) or PM10 (r = 0.73-0.93) reported from 26 September through 8 October 2001 at four of six sites near the WTC whose data we examined. Biomarkers were measured in a subset. Most (71%) of these women were located within eight blocks of the WTC at 0900 hr on 11 September, and 12 women were in one of the two WTC towers. Daily EIs were determined to be highest immediately after 11 September and became much lower but remained highly variable over the next 4 weeks. The weekly summary EI was associated strongly with women's perception of air quality from week 2 to week 4 after the collapse (p < 0.0001). The highest levels of polycyclic aromatic hydrocarbon-deoxyribonucleic acid (PAH-DNA) adducts were seen among women whose blood was collected sooner after 11 September, but levels showed no significant associations with EI or other potential WTC exposure sources. Lead and cobalt in urine were weakly correlated with sigmaEI, but not among samples collected closest to 11 September. Plasma OC levels were low. The median polychlorinated biphenyl level (sum of congeners 118, 138, 153, 180) was 84 ng/g lipid and had a nonsignificant positive association with sigmaEI (p > 0.05). 1,2,3,4,6,7,8-Heptachlorodibenzodioxin levels (median, 30 pg/g lipid) were similar to levels reported in WTC-exposed firefighters but were not associated with EI. This report indicates intense bystander exposure after the WTC collapse and provides information about nonoccupational exposures among a vulnerable population of pregnant women.

Background and Aim: Hypoalbuminemia in patients with decompensated cirrhosis has traditionally been assumed to be a result of to impaired liver synthesis; however, protein-losing enteropathy (PLE) may also contribute. The aim of this study was to assess whether hypoalbuminemic cirrhotic patients with portal hypertension had evidence of PLE., Methods: Sixteen patients with alcoholic cirrhosis, hypoalbuminemia and portal hypertension underwent whole gut lavage with polyethylene glycol solution. The effluent obtained was analyzed for albumin, immunoglobulin (Ig)G and alpha1-antitrypsin (alpha1-AT). Serum C-reactive protein (CRP) was also measured to assess the systemic inflammatory response., Results: Twelve of the 16 enrolled patients had a persistently low albumin concentration at the time of lavage. Only one patient (who was subsequently found to have celiac disease) had elevated concentrations of lavage albumin, alpha1-AT and IgG levels. There was a significant correlation between lavage albumin and alpha1-AT (r = 0.671, P = 0.024), and between lavage albumin and IgG (r = 0.614, P = 0.045). There was no correlation between serum albumin and lavage proteins. Six patients had elevated serum CRP levels, but serum albumin or lavage protein concentrations did not correlate with serum CRP., Conclusion: There is no evidence of a significant PLE in patients with alcoholic cirrhosis, hypoalbuminemia and portal hypertension.

Motivation: In microarray experiments, missing entries arise from blemishes on the chips. In large-scale studies, virtually every chip contains some missing entries and more than 90% of the genes are affected. Many analysis methods require a full set of data. Either those genes with missing entries are excluded, or the missing entries are filled with estimates prior to the analyses. This study compares methods of missing value estimation., Results: Two evaluation metrics of imputation accuracy are employed. First, the root mean squared error measures the difference between the true values and the imputed values. Second, the number of mis-clustered genes measures the difference between clustering with true values and that with imputed values; it examines the bias introduced by imputation to clustering. The Gaussian mixture clustering with model averaging imputation is superior to all other imputation methods, according to both evaluation metrics, on both time-series (correlated) and non-time series (uncorrelated) data sets.

Classification and regression tree methods represent a potentially powerful means of identifying patterns in exposure data that may otherwise be overlooked. Here, regression tree models are developed to identify associations between blood concentrations of benzene and lead and over 300 variables of disparate type (numerical and categorical), often with observations that are missing or below the quantitation limit. Benzene and lead are selected from among all the environmental agents measured in the NHEXAS Region V study because they are ubiquitous, and they serve as paradigms for volatile organic compounds (VOCs) and heavy metals, two classes of environmental agents that have very different properties. Two sets of regression models were developed. In the first set, only environmental and dietary measurements were employed as predictor variables, while in the second set these were supplemented with demographic and time-activity data. In both sets of regression models, the predictor variables were regressed on the blood concentrations of the environmental agents. Jack-knife cross-validation was employed to detect overfitting of the models to the data. Blood concentrations of benzene were found to be associated with: (a) indoor air concentrations of benzene; (b) the duration of time spent indoors with someone who was smoking; and (c) the number of cigarettes smoked by the subject. All these associations suggest that tobacco smoke is a major source of exposure to benzene. Blood concentrations of lead were found to be associated with: (a) house dust concentrations of lead; (b) the duration of time spent working in a closed workshop; and (c) the year in which the subject moved into the residence. An unexpected finding was that the regression trees identified time-activity data as better predictors of the blood concentrations than the measurements in environmental and dietary media.

Background: The aim of this study was to retrospectively evaluate the short-and long-term effectiveness of different methods of endoscopic treatment for bleeding Dieulafoy's lesions., Methods: Patients were allocated into 2 groups according to the hemostatic method applied: (1) injection group (epinephrine and/or ethanolamine oleate), and (2) thermal coagulation group (heat probe), either alone or combined with epinephrine injection. The combination of epinephrine and ethanolamine oleate was used in 5 patients, epinephrine alone in 3, ethanolamine oleate alone in one, heat probe and epinephrine in 8, and heat probe alone in 1 patient., Results: Dieulafoy's lesions were found in 18 (1%) of 1750 patients with acute nonvariceal upper GI bleeding. Comorbid conditions were present in 5 (28%) patients. Initial hemostasis was achieved endoscopically in 13 patients (72%) and permanent hemostasis in 17 patients (94%). Bleeding recurred in 5 patients (2 with concomitant disease) in the injection group; 3 were successfully retreated by heat probe coagulation and epinephrine injection, 1 with hemoclip application and 1 by surgery. There was no recurrent bleeding in thermal treatment group. Thermal treatment was significantly superior to injection (p = 0.0029)., Conclusions: Endoscopic thermal coagulation with or without epinephrine injection should be the initial treatment of choice for Dieulafoy's lesions. Mortality is lowest in patients with no significant comorbidity and an unremarkable medical history.

Glutamate dehydrogenase (GDH) specific activities, kinetic properties and allosteric regulation were studied in extracts from cultured neurons and astrocytes prepared from mouse cerebral cortex and cerebellum. Considerable differences were observed in the specific activity of the enzyme among the different cell types with astrocytes expressing the highest GDH activity. This may reflect the functional importance of these cells in glutamate uptake and metabolism. Among the neurons, the glutamatergic cerebellar granule cells showed a GDH specific activity that was 60% higher (P < 0.01) than that of the GABAergic cerebral cortical neurons. Also, the K(m) for ammonia was 1.7-fold higher in the cortical neurons than in the other cell types. These findings may reflect a particular need for the glutamatergic granule cells to synthesize glutamate via the GDH pathway. No differences were observed among the different cell types with regard to the allosteric properties of GDH expressed by these cells., (Copyright 2001 Wiley-Liss, Inc.)

This article provides an overview of the environmental patterns and dynamics of copper from the perspective of issues that affect our ability to examine current human exposures. It presents selected summary information on the levels of copper found in various media and exposure pathways from a variety of information sources, and discusses the breadth and the limitations of this information. The analysis presented focuses on the ability to provide quantitative values for both external metrics of exposures (microenvironmental levels) and internal biological markers of exposure. The status of the current information on environmental copper is placed within a conceptual framework that can be used to identify data gaps, assess the utility of current biological markers of exposure, and examine the need for systematic and consistent data-gathering studies to improve our ability to complete exposure assessments. A primary concern is the exposure to copper through potable water supplies; this is considered within a framework that examines copper levels and distribution in food, soil, air and sediments, as well as the levels found in biological media such as urine, blood, and hair. An existing water consumption model for copper and associated exposure factors is briefly discussed. This type of model will eventually be valuable within a total exposure analysis modeling framework that can consider and prioritize exposures from multiple routes and differentiate levels of concern for both excesses and deficiencies in exposure, an important issue, since copper is an essential nutrient. Finally, this review attempts to examine the needs for better information using as a basis the concerns briefly mentioned in the recent NRC report "Copper in Drinking Water" (National Research Council, 2000).

Detailed information on the composition-resolved size distribution of particulate matter deposited along the human respiratory tract can help linking epidemiological, toxicological, and pathological studies and thus potentially improve the understanding of the origin of pulmonary disorders induced by respirable pathogens. For this purpose, a new mechanistic dosimetry model describing the dynamics of respirable particles in the human airways was developed. Model predictions of transport and fate of inhaled aerosols are based on solutions of the aerosol general dynamic equation, which describes changes in particle size and mass distributions resulting from processes such as nucleation, condensation, coagulation, gas phase chemical reaction, and deposition. To compensate for approximating the three-dimensional problem by considering only axial variations along the airways, boundary layer effects are introduced via appropriate dimensionless transport parameters. The architecture of the human lung is described by Weibel's simple regular dichotomous model. An important advantage of the present approach is that it allows testing the significance of intersubject lung morphology and ventilation variability for particle deposition and dose calculations. The model predicts the evolution of size and composition distributions of inhaled particles and the deposition profile along the human lower respiratory tract: in general, model predictions are in qualitative and quantitative agreement with tracheobronchial and alveolar deposition data.

The consequences of spontaneously broken translational invariance on the nucleation-rate statistical prefactor in theories of first-order phase transitions are analyzed. A hybrid, semiphenomenological approach based on field-theoretic analyses of condensation and modern density-functional theories of nucleation is adopted to provide a unified prescription for the incorporation of translational-invariance corrections to nucleation-rate predictions. A connection between these theories is obtained starting from a quantum-mechanical Hamiltonian and using methods developed in the context of studies on Bose-Einstein condensation. An extremum principle is used to derive an integro-differential equation for the spatially nonuniform mean-field order-parameter profile; the appropriate order parameter becomes the square root of the fluid density. The importance of the attractive intermolecular potential is emphasized, whereas the repulsive two-body potential is approximated by considering hard-sphere collisions. The functional form of the degenerate translational eigenmodes in three dimensions is related to the mean-field order parameter, and their contribution to the nucleation-rate prefactor is evaluated. The solution of the Euler-Lagrange variational equation is discussed in terms of either a proposed variational trial function or the complete numerical solution of the associated boundary-value integro-differential problem. Alternatively, if the attractive potential is not explicitly known, an approach that allows its formal determination from its moments is presented.

Estimation of uncertainties associated with model predictions is an important component of the application of environmental and biological models. "Traditional" methods for propagating uncertainty, such as standard Monte Carlo and Latin Hypercube Sampling, however, often require performing a prohibitive number of model simulations, especially for complex, computationally intensive models. Here, a computationally efficient method for uncertainty propagation, the Stochastic Response Surface Method (SRSM) is coupled with another method, the Automatic Differentiation of FORTRAN (ADIFOR). The SRSM is based on series expansions of model inputs and outputs in terms of a set of "well-behaved" standard random variables. The ADIFOR method is used to transform the model code into one that calculates the derivatives of the model outputs with respect to inputs or transformed inputs. The calculated model outputs and the derivatives at a set of sample points are used to approximate the unknown coefficients in the series expansions of outputs. A framework for the coupling of the SRSM and ADIFOR is developed and presented here. Two case studies are presented, involving (1) a physiologically based pharmacokinetic model for perchloroethylene for humans, and (2) an atmospheric photochemical model, the Reactive Plume Model. The results obtained agree closely with those of traditional Monte Carlo and Latin hypercube sampling methods, while reducing the required number of model simulations by about two orders of magnitude.

Reconstruction of human exposure to toxic chemicals using physiologically based pharmacokinetic (PBPK) models and biomarkers is an attractive prospect, because biomarker measurements generally provide the most direct evidence of dose. Previously it has been shown that it is possible to reconstruct short-term (30 minute) exposure to chloroform, and that it is possible in some cases to resolve the total dose between two routes of uptake (Georgopoulos et al., 1994). In this paper it is shown that it is mathematically feasible to reconstruct longer term exposures to volatile organic compounds (VOCs), using benzene as a paradigm for other VOCs, and exhaled breath concentration as a biomarker of exposure. First, it is shown that exhaled breath concentration is an appropriate biomarker for long-term exposure to benzene, since benzene accumulates in fat and is eliminated in exhaled breath. Application of a benzene PBPK model (Travis et al., 1990) showed that benzene continues to accumulate in the fat compartment for over 10 days, and consequently fat acts as an integrator of dose during this period. Second, the benzene PBPK model is used to reconstruct exposure using the maximum likelihood approach. Since no data were available for long-term exposures of this duration, "data" with a normally distributed random error and 30% coefficient of variation were generated by the PBPK model for a variety of daily exposures. It was shown that in most cases it is possible to estimate cumulative exposure within 40% of the actual values, even when the exposure concentration-time profile is unknown. The estimated exposure is found to always be an underestimate of the true exposure when the exposure concentration is assumed to be constant.

Comprehensive uncertainty analyses of complex models of environmental and biological systems are essential but often not feasible due to the computational resources they require. "Traditional" methods, such as standard Monte Carlo and Latin Hypercube Sampling, for propagating uncertainty and developing probability densities of model outputs, may in fact require performing a prohibitive number of model simulations. An alternative is offered, for a wide range of problems, by the computationally efficient "Stochastic Response Surface Methods (SRSMs)" for uncertainty propagation. These methods extend the classical response surface methodology to systems with stochastic inputs and outputs. This is accomplished by approximating both inputs and outputs of the uncertain system through stochastic series of "well behaved" standard random variables; the series expansions of the outputs contain unknown coefficients which are calculated by a method that uses the results of a limited number of model simulations. Two case studies are presented here involving (a) a physiologically-based pharmacokinetic (PBPK) model for perchloroethylene (PERC) for humans, and (b) an atmospheric photochemical model, the Reactive Plume Model (RPM-IV). The results obtained agree closely with those of traditional Monte Carlo and Latin Hypercube Sampling methods, while significantly reducing the required number of model simulations.

This study presents a new set of metrics quantifying the response of photochemical air pollution systems to changes in 0 3 precursor levels. Extending the traditional approach of using domain-wide maximum ozone values as the metric for guiding the development of emission control strategies, the new metrics incorporate attributes of the spatial and temporal pervasiveness and the severity of the ozone episodes considered for strategy development, as well as the impact on potential exposures to ozone. The usefulness of using various alternative criteria to better understand the directionality of the impact of emission controls is demonstrated via a set of 26 simulations of a three-day period of the severe July 1988 episode over the New Jersey-Philadelphia-Delaware Valley area. These simulations model the effect of across-the-board reductions of VOC and NO by 25, 50, 75, and 100% of the base case. The impact of these reductions is found to be dependent on the control objective (e.g., reduction of exposure vs. reduction of the maximum) as well as on the targeted level of the control objective (e.g., reduction of exposures below 120 ppb vs. reduction of exposures below 80 ppb).

Photochemical modeling and ambient monitoring of ground-level ozone concentrations provide two alternative/complementary methods for calculating potential population exposure estimates. A comparative evaluation of these methods was undertaken over a study area comprised of the entire state of New Jersey and neighboring parts of Delaware, Maryland, Pennsylvania, and New York. Kriging, a geostatistical interpolation technique, was used for the interpolation of hourly ozone data from 38 air quality monitoring stations operating within the study area, to derive concentration fields for the entire domain. The Urban Airshed Model (UAM-IV), a comprehensive photochemical grid-based model, was then used to calculate the same concentrations from emissions and meteorology inputs. Concentration fields, thus developed, were linked with corresponding population data to calculate potential population exposure estimates to outdoor ozone (Ep.o). The adequacy of kriging as an interpolation technique was evaluated by comparing Ep.o estimates derived via photochemical UAM modeling with those calculated by using concentrations obtained from kriging UAM-calculated values at the locations of the monitoring stations. In general, UAM was found to predict higher Ep.o compared to those derived by kriging observations. In order to test the robustness of the interpolation methodology with respect to assumptions of statistical correlation, two different semivariogram models, spherical and exponential, were used for kriging. Application of the different semivariograms yielded almost identical Ep.o patterns.

Environmental exposures to benzene result in increases in body burden that are reflected in various biomarkers of exposure, including benzene in exhaled breath, benzene in blood and urinary trans-trans-muconic acid and S-phenylmercapturic acid. A review of the literature indicates that these biomarkers can be used to distinguish populations with different levels of exposure (such as smokers from nonsmokers and occupationally exposed from environmentally exposed populations) and to determine differences in metabolism. Biomarkers in humans have shown that the percentage of benzene metabolized by the ring-opening pathway is greater at environmental exposures than that at higher occupational exposures, a trend similar to that found in animal studies. This suggests that the dose-response curve is nonlinear; that potential different metabolic mechanisms exist at high and low doses; and that the validity of a linear extrapolation of adverse effects measured at high doses to a population exposed to lower, environmental levels of benzene is uncertain. Time-series measurements of the biomarker, exhaled breath, were used to evaluate a physiologically based pharmacokinetic (PBPK) model. Biases were identified between the PBPK model predictions and experimental data that were adequately described using an empirical compartmental model. It is suggested that a mapping of the PBPK model to a compartmental model can be done to optimize the parameters in the PBPK model to provide a future framework for developing a population physiologically based pharmacokinetic model.

The science of exposure assessment has been expanding both its theoretical and experimental bases over the past two years. Recent theoretical work published by the authors in the Journal of Exposure Analysis and Environmental Epidemiology (Volume 4, Number 3, 1994) has defined a multistep process to couple measurement data with mathematical models of exposure and dose. The present manuscript discusses the need for improving the measurement of exposure in order to reduce uncertainties in the potential risk and, eventually, the occurrences of health outcomes in the community environment. The discussion focuses on hazardous waste sites and how improving or routinely introducing exposure measurements to the remedial investigation can lead to a better understanding of how the potential population can get exposed via single or multiple activities. This information can help to better understand the need for specific remediation actions and selection of the types of models that can be used to predict exposure for a large population and to estimate the reduction in postremediation exposure for a local population (National Research Council, 1991).

The current methods for a reference dose (RfD) determination can be enhanced through the use of biologically-based dose response analysis. Methods developed here utilizes information from tetrachlorodibenzo-p-dioxin (TCDD) to focus on noncancer endpoints, specifically TCDD mediated immune system alterations and enzyme induction. Dose-response analysis, using the Sigmoid-Emax (EMAX) function, is applied to multiple studies to determine consistency of response. Through the use of multiple studies and statistical comparison of parameter estimates, it was demonstrated that the slope estimates across studies were very consistent. This adds confidence to the subsequent effect dose estimates. This study also compares traditional methods of risk assessment such as the NOAEL/safety factor to a modified benchmark dose approach which is introduced here. Confidence in the estimation of an effect dose (ED10) was improved through the use of multiple datasets. This is key to adding confidence to the benchmark dose estimates. In addition, the Sigmoid-Emax function when applied to dose-response data using nonlinear regression analysis provides a significantly improved fit to data increasing confidence in parameter estimates which subsequently improve effect dose estimates.

Estimates of dermal dose from exposures to toxic chemicals are typically derived using models that assume instantaneous establishment of steady-state dermal mass flux. However, dermal absorption theory indicates that this assumption is invalid for short-term exposures to volatile organic chemicals (VOCs). A generalized distributed parameter physiologically-based pharmacokinetic model (DP-PBPK), which describes unsteady state dermal mass flux via a partial differential equation (Fickian diffusion), has been developed for inhalation and dermal absorption of VOCs. In the present study, the DP-PBPK model has been parameterized for chloroform, and compared with two simpler PBPK models of chloroform. The latter are lumped parameter models, employing ordinary differential equations, that do not account for the dermal absorption time lag associated with the accumulation of permeant chemical in tissue represented by permeability coefficients. All three models were evaluated by comparing simulated post-exposure exhaled breath concentration profiles with measured concentrations following environmental chloroform exposures. The DP-PBPK model predicted a time-lag in the exhaled breath concentration profile, consistent with the experimental data. The DP-PBPK model also predicted significant volatilization of chloroform, for a simulated dermal exposure scenario. The end-exposure dermal dose predicted by the DP-PBPK model is similar to that predicted by the EPA recommended method for short-term exposures, and is significantly greater than the end-exposure dose predicted by the lumped parameter models. However, the net dermal dose predicted by the DP-PBPK model is substantially less than that predicted by the EPA method, due to the post-exposure volatilization predicted by the DP-PBPK model. Moreover, the net dermal dose of chloroform predicted by all three models was nearly the same, even though the lumped parameter models did not predict substantial volatilization.

As part of the current reassessment of dioxin, the empirical relationships between administered tetrachlorodibenzo-p-dioxin and selected immune and biochemical endpoints were investigated. A dose-response analysis from the published literature was performed using Linear, Sigmoid-Emax and Power Law functions. The results of this analysis indicate that the use of a wide dose range may bias the interpretation of low-dose phenomenon. The Power Law function was applied exclusively to low-dose subsets enabling estimation of dose response in the low-dose range. Subsequently, high-dose data were fit using Power Law subset analysis. This approach resulted in a change in slope value from low- to high-dose subsets for thymic atrophy, immune suppression, benzo(a)pyrene hydroxylase activity, and ethoxyresorufin-o-deethylase activity. This change suggests that there is a high probability that there is a tissue concentration along the dose-response continuum which results in biological activity from low to high dose. This analysis also demonstrates that the Power Law functional fit to the low-dose data differs quantitatively from the fit to the high-dose data for several noncancer endpoints. Therefore, by using the Power Law function a more accurate and biologically relevant assessment of risk can be produced for non-cancer endpoints.

The Clean Air Act Amendments (CAAA) of 1990 have established selected comprehensive, three-dimensional, Photochemical Air Quality Simulation Models (PAQSMs) as the required regulatory tools for analyzing the urban and regional problem of high ambient ozone levels across the United States. These models are currently applied to study and establish strategies for meeting the National Ambient Air Quality Standard (NAAQS) for ozone in nonattainment areas; State Implementation Plans (SIPs) resulting from these efforts must be submitted to the U.S. Environmental Protection Agency (U.S. EPA) in November 1994. The following presentation provides an overview and discussion of the regulatory ozone modeling process and its implications. First, the PAQSM-based ozone attainment demonstration process is summarized in the framework of the 1994 SIPs. Then, following a brief overview of the representation of physical and chemical processes in PAQSMs, the essential attributes of standard modeling systems currently in regulatory use are presented in a nonmathematical, self-contained format, intended to provide a basic understanding of both model capabilities and limitations. The types of air quality, emission, and meteorological data needed for applying and evaluating PAQSMs are discussed, as well as the sources, availability, and limitations of existing databases. The issue of evaluating a model's performance in order to accept it as a tool for policy making is discussed, and various methodologies for implementing this objective are summarized. Selected interim results from diagnostic analyses, which are performed as a component of the regulatory ozone modeling process for the Philadelphia-New Jersey region, are also presented to provide some specific examples related to the general issues discussed in this work. Finally, research needs related to a) the evaluation and refinement of regulatory ozone modeling, b) the characterization of uncertainty in photochemical modeling, and c) the improvement of the model-based ozone-attainment demonstration process are presented to identify future directions in this area.

Rates of cerebral glucose utilization were measured by means of the autoradiographic 2-deoxy-D-[1-14C] glucose technique in 70 anatomically discrete central nervous structures in conscious awake rats following unilateral intranigral application of the GABAergic agonist muscimol. Intranigral injection of 1.3 microliters 1 microM muscimol (0.15 ng) induced increases in glucose consumption locally in the substantia nigra reticulata (by 87%), distally in the contralateral reticulata, red nucleus, nucleus accumbens, and prefrontal cortex, and bilaterally in the pyriform cortex, as compared to values in control animals. Intranigral injection of 1.3 microliters 1 mM muscimol (150 ng) effected a local metabolic activation in the substantia nigra reticulata (by 111% compared to the control group) and in compacta (by 18%), as well as a distal activation in the contralateral reticulata (by 39%) and contralateral compacta (by 29%). Beyond the structures affected by the lower dose, the higher dose of muscimol elicited widespread bilateral increases in glucose metabolism in the rat brain. Among the principal nigral reticulata efferent projections, the deep superior colliculi displayed ipsilateral metabolic activation (by 30%), whereas the parafascicular, mediodorsal, and ventromedial thalamic projecting areas, as well as the pedunculopontine nucleus, displayed bilateral activations compared to the control animals. The ventromedial and ventrolateral thalamic nuclei contralateral to the injected substantia nigra reticulata were 20% activated compared to the ipsilateral homologous structures and 30% activated compared to the control rats. The areas that send afferent projections to the reticulata (globus pallidus, entopeduncular and subthalamic nuclei) were mainly activated contralateral to the injected reticulata compared to values for control animals. In general, following intranigral muscimol (1 mM) injection, glucose metabolism was activated to a larger extent on the side contralateral to the injection than on the ipsilateral side. It is suggested that the present findings are due to a presynaptic nigral effect of muscimol on the GABAergic autoreceptors of the striatonigral terminals and to a consequent disinhibition of the reticulata GABAergic output.