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1.
Environ Toxicol Chem ; 42(2): 495-511, 2023 02.
Article in English | MEDLINE | ID: mdl-36349955

ABSTRACT

We monitored physical-chemical conditions in the North Fork of Clear Creek in Colorado (USA) before, during, and after the start of remediation (lime treatment) to remove metals from two major inputs of acid mine drainage (AMD) water. In addition, we analyzed historical monitoring data that extended back more than two decades. Concentration-discharge (C-D) and load-discharge (L-D) plots accounted for discharge dependence in concentrations and loads of metals, major ions, and other water chemistry parameters. Total and dissolved concentrations, and loads of the metals decreased after remediation began, with the largest decreases usually during low stream flow. However, postremediation concentrations and loads remained slightly to considerably higher than reference, probably because of unidentified groundwater seeps and/or small surface flows. Dissolved Cu concentrations decreased much less than total Cu concentrations, because the percentage of total Cu in the dissolved phase increased considerably as particulate Fe (PFe) concentration decreased. We conclude that 1) water chemistry can change to a new steady state or pseudo-steady state relatively quickly after major AMD inputs to a stream are remediated; 2) elevated flows during snowmelt and rainfall periods can mobilize additional amounts of major ions and metals, resulting in in-stream concentrations that are manifestations of both dilution and mobilization; 3) although lime treatment of AMD-related waters can decrease metal concentrations, it does not decrease elevated concentrations of major ions that might impair sensitive stream invertebrates; 4) although Fe is toxic to aquatic organisms, PFe adsorbs other metals and thereby provides protection against their toxicity; and 5) use of C-D and L-D plots and element ratios can indicate the presence of unidentified AMD inputs to a stream. Environ Toxicol Chem 2023;42:495-511. © 2022 SETAC.


Subject(s)
Rivers , Water Pollutants, Chemical , Rivers/chemistry , Water Pollutants, Chemical/analysis , Metals , Water , Environmental Monitoring
2.
Environ Toxicol Chem ; 42(2): 449-462, 2023 02.
Article in English | MEDLINE | ID: mdl-36484737

ABSTRACT

Dissolved copper (Cu) can contribute to toxicity in aquatic systems impacted by acid mine drainage (AMD), and its bioavailability is influenced by aqueous complexation with organic ligands that predominantly include fulvic acids (FAs). Because the geochemical fractionation of FAs that accompanies sorption to hydrous aluminum oxides (HAOs) and hydrous iron oxides (HFOs) can alter Cu complexation with FA, we investigated FAs isolated from three categories of water (pristine, AMD, and in situ-fractionated mixtures of pristine and AMD collected at stream confluences) in three mining-impacted alpine watersheds in central Colorado, USA. We also conducted geochemical fractionation of field-collected FAs and Suwannee River FAs by precipitating HAOs and HFOs in the laboratory. Spectral properties of the FAs (e.g., UV-VIS absorbance) were altered by geochemical fractionation, and in acute toxicity tests with an aquatic invertebrate (Daphnia magna) Cu was more toxic in the presence of in situ- and laboratory-fractionated FAs (median effect concentration [EC50] 19-50 µg Cu L-1 ) than in the presence of nonfractionated FAs (EC50 48-146 µg Cu L-1 ). After adjusting for the strain-specific sensitivity of our D. magna, we improved the accuracy of Biotic Ligand Model predictions of Cu EC50 values for AMD-related FAs by using an "effective dissolved organic carbon" based on spectral properties that account for among-FA differences in protectiveness against Cu toxicity. However, some differences remained between predicted and measured EC50 values, especially for FAs from AMD-related waters that might contain important metal-binding moieties not accounted for by our measured spectral indices. Environ Toxicol Chem 2023;42:449-462. © 2022 SETAC.


Subject(s)
Copper , Water Pollutants, Chemical , Animals , Copper/toxicity , Copper/chemistry , Daphnia , Benzopyrans , Water , Ligands , Water Pollutants, Chemical/chemistry
3.
Environ Toxicol Chem ; 42(2): 512-524, 2023 02.
Article in English | MEDLINE | ID: mdl-36345954

ABSTRACT

Responses of stream ecosystems to gradual reductions in metal loading following remediation or restoration activities have been well documented in the literature. However, much less is known about how these systems respond to the immediate or more rapid elimination of metal inputs. Construction of a water treatment plant on the North Fork of Clear Creek (NFCC; CO, USA), a US Environmental Protection Agency Superfund site, captured, diverted, and treated the two major point-source inputs of acid mine drainage (AMD) and provided an opportunity to investigate immediate improvements in water quality. We conducted a 9-year study that included intensive within- and among-year monitoring of receiving-stream chemistry and benthic communities before and after construction of the treatment plant. Results showed a 64%-86% decrease in metal concentrations within months at the most contaminated sites. Benthic communities responded with increased abundance and diversity, but downstream stations remained impaired relative to reference conditions, with significantly lower taxonomic richness represented by a few dominant taxa (i.e., Baetis sp., Hydropsyche sp., Simulium sp., Orthocladiinae). Elevated metal concentrations from apparent residual sources, and relatively high conductivity from contributing major ions not removed during the treatment process, are likely limiting downstream recovery. Our study demonstrates that direct AMD treatment can rapidly improve water quality and benefit aquatic life, but effectiveness is limited, in part, to the extent that inputs of metals are captured and treated. Consideration should also be given to the effects of elevated major ion concentrations from the treated effluent not removed during the lime treatment process. Continued chemical and biological monitoring will be needed to quantify the NFCC recovery trajectory and to inform future remediation strategies. Environ Toxicol Chem 2023;42:512-524. © 2022 The Authors. Environmental Toxicology and Chemistry published by Wiley Periodicals LLC on behalf of SETAC. This article has been contributed to by U.S. Government employees and their work is in the public domain in the USA.


Subject(s)
Ecosystem , Water Pollutants, Chemical , Humans , Animals , Environmental Monitoring/methods , Metals , Water Quality , Mining , Acids
4.
J Am Heart Assoc ; 11(23): e026304, 2022 12 06.
Article in English | MEDLINE | ID: mdl-36444837

ABSTRACT

Background ATP-sensitive potassium channels are inhibited by ATP and open during metabolic stress, providing endogenous myocardial protection. Pharmacologic opening of ATP potassium channels with diazoxide preserves myocardial function following prolonged global ischemia, making it an ideal candidate for use during cardiac surgery. We hypothesized that diazoxide would reduce myocardial stunning after regional ischemia with subsequent prolonged global ischemia, similar to the clinical situation of myocardial ischemia at the time of revascularization. Methods and Results Swine underwent left anterior descending occlusion (30 minutes), followed by 120 minutes global ischemia protected with hyperkalemic cardioplegia±diazoxide (N=6 each), every 20 minutes cardioplegia, then 60 minutes reperfusion. Cardiac output, time to wean from cardiopulmonary bypass, left ventricular (LV) function, caspase-3, and infarct size were compared. Six animals in the diazoxide group separated from bypass by 30 minutes, whereas only 4 animals in the cardioplegia group separated. Diazoxide was associated with shorter but not significant time to wean from bypass (17.5 versus 27.0 minutes; P=0.13), higher, but not significant, cardiac output during reperfusion (2.9 versus 1.5 L/min at 30 minutes; P=0.05), and significantly higher left ventricular ejection fraction at 30 minutes (42.5 versus 15.8%; P<0.01). Linear mixed regression modeling demonstrated greater left ventricular developed pressure (P<0.01) and maximum change in ventricular pressure during isovolumetric contraction (P<0.01) in the diazoxide group at 30 minutes of reperfusion. Conclusions Diazoxide reduces myocardial stunning and facilitates separation from cardiopulmonary bypass in a model that mimics the clinical setting of ongoing myocardial ischemia before revascularization. Diazoxide has the potential to reduce myocardial stunning in the clinical setting.


Subject(s)
Myocardial Ischemia , Myocardial Stunning , Swine , Animals , Diazoxide/pharmacology , Myocardial Stunning/etiology , Myocardial Stunning/prevention & control , KATP Channels , Stroke Volume , Ventricular Function, Left , Ischemia , Myocardial Ischemia/complications , Myocardial Ischemia/drug therapy , Adenosine Triphosphate
5.
Environ Sci Technol ; 56(22): 16538-16540, 2022 Nov 15.
Article in English | MEDLINE | ID: mdl-36219816
6.
PLoS One ; 17(8): e0273572, 2022.
Article in English | MEDLINE | ID: mdl-36037158

ABSTRACT

Current estimates of terrestrial bird losses across Europe from ingestion of lead ammunition are based on uncertain or generic assumptions. A method is needed to develop defensible European-specific estimates compatible with available data that does not require long-term field studies. We propose a 2-step method using carcass data and population models. The method estimates percentage of deaths diagnosed as directly caused by lead poisoning as a lower bound and, as an upper bound, the percentage of possible deaths from sublethal lead poisoning that weakens birds, making them susceptible to death by other causes. We use these estimates to modify known population-level annual mortality. Our method also allows for potential reductions in reproduction from lead shot ingestion because reductions in survival and reproduction are entered into population models of species with life histories representative of the most groups of susceptible species. The models estimate the sustainability and potential population decreases from lead poisoning in Europe. Using the best available data, we demonstrate the method on two taxonomic groups of birds: gallinaceous birds and diurnal raptors. The direction of the population trends affects the estimate, and we incorporated such trends into the method. Our midpoint estimates of the reduction in population size of the European gallinaceous bird (< 2%) group and raptor group (2.9-7.7%) depend on the species life history, maximum growth rate, population trend, and if reproduction is assumed to be reduced. Our estimates can be refined as more information becomes available in countries with data gaps. We advocate use of this method to improve upon or supplement approaches currently being used. As we demonstrate, the method also can be applied to individual species of concern if enough data across countries are available.


Subject(s)
Lead Poisoning , Raptors , Animals , Birds , Eating , Lead/toxicity , Lead Poisoning/epidemiology , Lead Poisoning/veterinary , Population Dynamics
7.
Echocardiography ; 39(9): 1198-1208, 2022 09.
Article in English | MEDLINE | ID: mdl-35907784

ABSTRACT

BACKGROUND: The ratio of tricuspid annular plane systolic excursion (TAPSE) to pulmonary artery systolic pressure (PASP) is a validated index of right ventricular-pulmonary arterial (RV-PA) coupling with prognostic value. We determined the predictive value of TAPSE/PASP ratio and adverse clinical outcomes in hospitalized patients with COVID-19. METHODS: Two hundred and twenty-nine consecutive hospitalized racially/ethnically diverse adults (≥18 years of age) admitted with COVID-19 between March and June 2020 with clinically indicated transthoracic echocardiograms (TTE) that included adequate tricuspid regurgitation (TR) velocities for calculation of PASP were studied. The exposure of interest was impaired RV-PA coupling as assessed by TAPSE/PASP ratio. The primary outcome was in-hospital mortality. Secondary endpoints comprised of ICU admission, incident acute respiratory distress syndrome (ARDS), and systolic heart failure. RESULTS: One hundred and seventy-six patients had both technically adequate TAPSE measurements and measurable TR velocities for analysis. After adjustment for age, sex, BMI, race/ethnicity, diabetes mellitus, and smoking status, log(TAPSE/PASP) had a significantly inverse association with ICU admission (p = 0.015) and death (p = 0.038). ROC analysis showed the optimal cutoff for TAPSE/PASP for death was 0.51 mm mmHg-1 (AUC = 0.68). Unsupervised machine learning identified two groups of echocardiographic function. Of all echocardiographic measures included, TAPSE/PASP ratio was the most significant in predicting in-hospital mortality, further supporting its significance in this cohort. CONCLUSION: Impaired RV-PA coupling, assessed noninvasively via the TAPSE/PASP ratio, was predictive of need for ICU level care and in-hospital mortality in hospitalized patients with COVID-19 suggesting utility of TAPSE/PASP in identification of poor clinical outcomes in this population both by traditional statistical and unsupervised machine learning based methods.


Subject(s)
COVID-19 , Ventricular Dysfunction, Right , Adult , Humans , Echocardiography, Doppler , Prognosis , Prospective Studies , Unsupervised Machine Learning , Ventricular Function, Right
8.
Environ Sci Technol ; 56(4): 2794-2802, 2022 02 15.
Article in English | MEDLINE | ID: mdl-35090113

ABSTRACT

Earth's nitrogen (N) cycle is imbalanced because of excessive anthropogenic inputs. Freshwater lakes efficiently remove N from surface waters by transformation of NO3- to atmospheric N2 and/or N2O (denitrification; DN) and by burial of organic N in sediments (net sedimentation; NS). However, relatively little is known about the controlling environmental conditions, and few long-term measurements on individual lakes are available to quantify conversion rates. We report N-elimination rates in 21 Swiss lakes estimated from whole-lake N budgets covering up to ∼20 years of monitoring. The NO3- concentration in the bottom water was the main predictor of DN. Additionally, DN rates were positively correlated with external N load and the area-specific hydraulic loading rate (mean depth/water residence time; Qs). NS of N was strongly related to total phosphorus (P) concentration. Nitrogen removal efficiency (NRE), the fraction of the load of dissolved N to a lake removed by DN and NS, was strongly negatively related to Qs. This previously unconsidered variable improves the predictability of NRE and does not require knowledge of N and P loading rates or concentrations. We conclude that P management alone intended to oligotrophy lakes only slightly increases N export unless it is accompanied by N management.


Subject(s)
Lakes , Nitrogen , China , Denitrification , Environmental Monitoring , Geologic Sediments , Nitrogen/analysis , Phosphorus , Switzerland , Water
9.
JAMA Cardiol ; 7(1): 45-54, 2022 01 01.
Article in English | MEDLINE | ID: mdl-34613348

ABSTRACT

Importance: Smoking is a key modifiable risk factor in the development and progression of peripheral artery disease, which often manifests as intermittent claudication (IC). Smoking cessation is a first-line therapy for IC, yet a minority of patients quit smoking prior to elective revascularization. Objective: To assess if preprocedural smoking is associated with an increased risk of early postprocedural complications following elective open and endovascular revascularization. Design, Setting, and Participants: This retrospective cohort study used nearest-neighbor (1:1) propensity score matching of 2011 to 2019 data from the Veterans Affairs Surgical Quality Improvement Program, including all cases with a primary diagnosis of IC and excluding emergent cases, primary procedures that were not lower extremity revascularization, and patients with chronic limb-threatening ischemia within 30 days of the intervention. All data were abstracted June 18, 2020, and analyzed from July 26, 2020, to June 30, 2021. Exposures: Preprocedural cigarette smoking. Main Outcomes and Measures: Any and organ system-specific (ie, wound, respiratory, thrombosis, kidney, cardiac, sepsis, and neurological) 30-day complications and mortality, overall and in prespecified subgroups. Results: Of 14 350 included cases of revascularization, 14 090 patients (98.2%) were male, and the mean (SD) age was 65.7 (7.0) years. A total of 7820 patients (54.5%) were smoking within the preprocedural year. There were a total of 4417 endovascular revascularizations (30.8%), 4319 hybrid revascularizations (30.1%), and 5614 open revascularizations (39.1%). A total of 1594 patients (11.1%) had complications, and 57 (0.4%) died. Among 7710 propensity score-matched cases (including 3855 smokers and 3855 nonsmokers), 484 smokers (12.6%) and 34 nonsmokers (8.9%) experienced complications, an absolute risk difference (ARD) of 3.68% (95% CI, 2.31-5.06; P < .001). Compared with nonsmokers, any complication was higher for smokers following endovascular revascularization (26 [4.3%] vs 52 [2.1%]; ARD, 2.19%; 95% CI, 0.77-3.60; P = .003), hybrid revascularization (204 [17.3%] vs 163 [14.1%]; ARD, 3.18%; 95% CI, 0.23-6.13; P = .04), and open revascularization (228 [15.4%] vs 153 [10.3%]; ARD, 5.18%; 95% CI, 2.78-7.58; P < .001). Compared with nonsmokers, respiratory complications were higher for smokers following endovascular revascularization (20 [1.7%] vs 6 [0.5%]; ARD, 1.17%; 95% CI, 0.35-2.00; P = .009), hybrid revascularization (33 [2.8%] vs 10 [0.9%]; ARD, 1.93%; 95% CI, 0.85-3.02; P = .001), and open revascularization (32 [2.2%] vs 19 [1.3%]; ARD, 0.89%; 95% CI, 0-1.80; P = .06). Wound complications and graft failure were higher for smokers compared with nonsmokers following open interventions (wound complications: 146 [9.9%] vs 87 [5.8%]; ARD, 4.05%; 95% CI, 2.12-5.99; P < .001; graft failure: 33 [2.2%] vs 11 [0.7%]; ARD, 1.50%; 95% CI, 0.63-2.37; P = .001). In a sensitivity analysis, compared with active smokers (n = 5173; smoking within 2 weeks before the procedure), the risk of any complication was decreased by 65% for never smokers (n = 1197; adjusted odds ratio, 0.45; 95% CI, 0.34-0.59) and 29% for former smokers (n = 4755; cessation more than 1 year before the procedure; adjusted odds ratio, 0.71; 95% CI, 0.61-0.83; P = .001 for interaction). Conclusions and Relevance: In this cohort study, more than half of patients with IC were smoking prior to elective revascularization, and complication risks were higher across all modalities of revascularization. These findings stress the importance of smoking cessation to optimize revascularization outcomes.


Subject(s)
Endovascular Procedures/adverse effects , Intermittent Claudication/surgery , Postoperative Complications/etiology , Risk Assessment/methods , Smoking/adverse effects , Aged , Female , Follow-Up Studies , Humans , Intermittent Claudication/etiology , Lower Extremity/blood supply , Male , Postoperative Complications/epidemiology , Retrospective Studies , Risk Factors , Time Factors , United States/epidemiology
10.
Front Cardiovasc Med ; 8: 728654, 2021.
Article in English | MEDLINE | ID: mdl-34722661

ABSTRACT

Aims: Inflammation plays a critical role in the pathogenesis of coronary artery disease (CAD), however the impact of anti-inflammatory therapies to reduce those processes which promote atherosclerosis in CAD patients is unknown. We aimed to test the hypothesis that anti-inflammatory approaches improve impaired coronary endothelial function (CEF), a driver of coronary atherosclerosis, in stable CAD patients. Methods and Results: We performed a single-center, randomized, placebo-controlled, double-blinded trial to assess whether low dose methotrexate (MTX), low dose colchicine (LDC), and/or their combination (MTX+LDC), improves CEF using non-invasive MRI measures in patients with stable CAD (N = 94). The primary endpoint was the MRI-detected change in coronary cross-sectional area from rest to isometric handgrip exercise (IHE), a predominantly nitric oxide-dependent endothelial dependent stressor. Coronary and systemic endothelial endpoints, and serum inflammatory markers, were collected at baseline, 8 and 24 weeks. Anti-inflammatory study drugs were well-tolerated. There were no significant differences in any of the CEF parameters among the four groups (MTX, LDC, MTX+LDC, placebo) at 8 or 24 weeks. Serum markers of inflammation and systemic endothelial function measures were also not significantly different among the groups. Conclusion: This is the first study to examine the effects of the anti-inflammatory approaches using MTX, LDC, and/or the combination in stable CAD patients on CEF, a marker of vascular health and the primary endpoint of the study. Although these anti-inflammatory approaches were relatively well-tolerated, they did not improve coronary endothelial function in patients with stable CAD. Clinical Trial Registration: www.clinicaltrials.gov, identifier: NCT02366091.

11.
AIDS ; 35(7): 1041-1050, 2021 06 01.
Article in English | MEDLINE | ID: mdl-33587443

ABSTRACT

OBJECTIVES: People living with HIV (PWH) experience an increased burden of coronary artery disease (CAD) believed to be related, in part, to an interplay of chronically increased inflammation and traditional risk factors. Recent trials suggest cardiovascular benefits of the anti-inflammatory, colchicine, in HIV-seronegative CAD patients. However, the impact of colchicine on impaired vascular health, as measured by coronary endothelial function (CEF), an independent contributor to CAD, has not been studied in PWH. We tested the hypothesis that colchicine improves vascular health in PWH. DESIGN: This was a randomized, placebo-controlled, double-blinded trial in 81 PWH to test whether low-dose colchicine (0.6 mg daily) improves CEF over 8-24 weeks. METHODS: Coronary and systemic endothelial function and serum inflammatory markers were measured at baseline, and at 8 and 24 weeks. The primary endpoint was CEF, measured as the change in coronary blood flow from rest to that during an isometric handgrip exercise, an endothelial-dependent stressor, measured with non-invasive MRI at 8 weeks. RESULTS: Colchicine was well tolerated and not associated with increased adverse events. However, there were no significant improvements in coronary or systemic endothelial function or reductions in serum inflammatory markers at 8 or 24 weeks with colchicine as compared to placebo. CONCLUSIONS: In PWH with no history of CAD, low-dose colchicine was well tolerated but did not improve impaired coronary endothelial function, a predictor of cardiovascular events. These findings suggest that this anti-inflammatory approach using colchicine in PWH does not improve vascular health, the central, early driver of coronary atherosclerosis.


Subject(s)
Coronary Artery Disease , HIV Infections , Colchicine/adverse effects , Double-Blind Method , HIV Infections/complications , HIV Infections/drug therapy , Hand Strength , Humans
12.
Environ Toxicol Chem ; 39(10): 1861-1883, 2020 10.
Article in English | MEDLINE | ID: mdl-32619073

ABSTRACT

We reviewed the literature on toxicity of nanoparticulate nickel (nano-Ni) to aquatic organisms, from the perspective of relevance and reliability in a regulatory framework. Our main findings were 1) much of the published nano-Ni toxicity data is of low or medium quality in terms of reporting key physical-chemical properties, methodologies, and results, compared with published dissolved nickel studies; and 2) based on the available information, some common findings about nanoparticle (NP) toxicity are not supported for nano-Ni. First, we concluded that nanoparticulate elemental nickel and nickel oxide, which differ in chemical composition, generally did not differ in their toxicity. Second, there is no evidence that the toxicity of nano-Ni increases as the size of the NPs decreases. Third, for most organisms tested, nano-Ni was not more toxic on a mass-concentration basis than dissolved Ni. Fourth, there is conflicting evidence about whether the toxicity is directly caused by the NPs or by the dissolved fraction released from the NPs. However, no evidence suggests that any of the molecular, physiological, and structural mechanisms of nano-Ni toxicity differ from the general pattern for many metal-based nanomaterials, wherein oxidative stress underlies the observed effects. Physical-chemical factors in the design and conduct of nano-Ni toxicity tests are important, but often they are not adequately reported (e.g., characteristics of dry nano-Ni particles and of wetted particles in exposure waters; exposure-water chemistry). Environ Toxicol Chem 2020;39:1861-1883 © 2020 The Authors. Environmental Toxicology and Chemistry published by Wiley Periodicals LLC on behalf of SETAC.


Subject(s)
Aquatic Organisms/drug effects , Nanoparticles/toxicity , Nickel/toxicity , Toxicity Tests , Water Pollutants, Chemical/toxicity , Animals , Oxidative Stress/drug effects , Reproducibility of Results , Toxicity Tests/methods , Toxicity Tests/standards
13.
Environ Toxicol Chem ; 39(1): 101-117, 2020 01.
Article in English | MEDLINE | ID: mdl-31880834

ABSTRACT

Regulatory jurisdictions worldwide are increasingly incorporating bioavailability-based toxicity models into development of protective values (PVALs) for freshwater and saltwater aquatic life (e.g., water quality criteria, standards, and/or guidelines) for metals. Use of such models for regulatory purposes should be contingent on their ability to meet performance criteria as specified through a model-validation process. Model validation generally involves an assessment of a model's appropriateness, relevance, and accuracy. We review existing guidance for validation of bioavailability-based toxicity models, recommend questions that should be addressed in model-validation studies, discuss model study type and design considerations, present several new ways to evaluate model performance in validation studies, and suggest a framework for use of model validation in PVAL development. We conclude that model validation should be rigorous but flexible enough to fit the user's purpose. Although a model can never be fully validated to a level of zero uncertainty, it can be sufficiently validated to fit a specific purpose. Therefore, support (or lack of support) for a model should be presented in such a way that users can choose their own level of acceptability. We recommend that models be validated using experimental designs and endpoints consistent with the data sets that were used to parameterize and calibrate the model and validated across a broad range of geographically and ecologically relevant water types. Environ Toxicol Chem 2019;39:101-117. © 2019 SETAC.


Subject(s)
Aquatic Organisms/drug effects , Environmental Monitoring/methods , Fresh Water/chemistry , Metals , Models, Biological , Water Pollutants, Chemical , Animals , Aquatic Organisms/metabolism , Biological Availability , Environmental Monitoring/legislation & jurisprudence , Metals/metabolism , Metals/toxicity , Reproducibility of Results , Species Specificity , Water Pollutants, Chemical/metabolism , Water Pollutants, Chemical/toxicity , Water Quality
14.
Am J Med ; 132(6): e569-e580, 2019 06.
Article in English | MEDLINE | ID: mdl-30710541

ABSTRACT

Efforts to better control risk factors for cardiovascular disease and prevent the development of subsequent events are crucial to maintaining healthy populations. In today's busy practice environment and with the overwhelming pace of new research findings, ensuring appropriate emphasis and implementation of evidence-based preventive cardiovascular care can be challenging. The ABCDEF approach to cardiovascular disease prevention is intended to improve dissemination of contemporary best practices and facilitate the implementation of comprehensive preventive strategies for clinicians. This review serves as a succinct yet authoritative overview for internists and subspecialty cardiologists not otherwise focused on cardiovascular prevention. The goal of this 2-part series is to compile a state-of-the-art list of elements central to both primary and secondary prevention of cardiovascular disease, using an ABCDEF checklist, with particular focus on recent society guideline updates. In Part 1 we highlight developments in cardiovascular risk assessment tools, summarize important recent aspirin trials, discuss prevention considerations in atrial fibrillation, and review guidelines for blood pressure categorization, goals, and therapy.


Subject(s)
Cardiovascular Diseases/prevention & control , Cardiovascular Diseases/therapy , Humans , Risk Factors
15.
Am J Med ; 132(7): e599-e609, 2019 07.
Article in English | MEDLINE | ID: mdl-30716297

ABSTRACT

Efforts to better control risk factors for cardiovascular disease and prevent the development of subsequent cardiovascular events are crucial to maintaining healthy populations. In today's busy practice environment and with the overwhelming pace of new research findings, ensuring appropriate emphasis and implementation of evidence-based preventive cardiovascular care can be challenging. The ABCDEF approach to cardiovascular disease prevention is intended to improve dissemination of contemporary best practices and ease the implementation of comprehensive preventive strategies for clinicians. This review serves as a succinct yet authoritative overview for interested internists as well as for cardiologists not otherwise focused on cardiovascular disease prevention. The goal of this 2-part series is to compile a state-of-the-art list of elements central to primary and secondary prevention of cardiovascular disease, using an ABCDEF checklist. In Part 2, we review new recommendations about lipid-modifying strategies, contemporary best practice for tobacco cessation, new evidence related to cardiovascular risk reduction in diabetes using novel therapies, ways to implement a heart-healthy diet, modern interventions to improve physical exercise, and how best to prevent the onset of heart failure.


Subject(s)
Cardiovascular Diseases/prevention & control , Diabetes Mellitus, Type 2/drug therapy , Diet , Exercise , Humans , Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use , Hypercholesterolemia/drug therapy , Hypoglycemic Agents/therapeutic use , Hypolipidemic Agents/therapeutic use , Risk Assessment , Smoking Cessation
16.
Environ Toxicol Chem ; 37(6): 1515-1522, 2018 06.
Article in English | MEDLINE | ID: mdl-29442368

ABSTRACT

There is concern over whether regulatory criteria for copper (Cu) are protective against chemosensory and behavioral impairment in aquatic organisms. We compiled Cu toxicity data for these and other sublethal endpoints in 35 tests with saltwater organisms and compared the Cu toxicity thresholds with biotic ligand model (BLM)-based estimated chronic limits (ECL values, which are 20% effect concentrations [EC20s] for the embryo-larval life stage of the blue mussel [Mytilus edulis], a saltwater species sensitive to Cu that has historically been used to derive saltwater Cu criteria). Only 8 of the 35 tests had sufficient toxicity and chemistry data to support unequivocal conclusions (i.e., a Cu EC20 or no-observed-effect concentration could be derived, and Cu and dissolved organic carbon [DOC] concentrations were measured [or DOC concentrations could be inferred from the test-water source]). The BLM-based ECL values would have been protective (i.e., the ECL was lower than the toxicity threshold) in 7 of those 8 tests. In the remaining 27 tests, this meta-analysis was limited by several factors, including 1) the Cu toxicity threshold was a "less than" value in 19 tests because only a lowest-observed-effect concentration could be calculated and 2) Cu and/or DOC concentrations often were not measured. In 2 of those 27 tests, the ECL would not have been protective if based only on a conservatively high upper-bound DOC estimate. To facilitate future evaluations of the protectiveness of aquatic life criteria for metals, we urge researchers to measure and report exposure-water chemistry and test-metal concentrations that bracket regulatory criteria. Environ Toxicol Chem 2018;37:1515-1522. © 2018 SETAC.


Subject(s)
Aquatic Organisms/drug effects , Behavior, Animal/drug effects , Copper/toxicity , Smell/drug effects , Water Pollutants, Chemical/toxicity , Animals , Ligands , Mytilus edulis/drug effects , Salmonidae , Seawater , Toxicity Tests, Chronic
17.
Environ Toxicol Chem ; 37(5): 1260-1279, 2018 05.
Article in English | MEDLINE | ID: mdl-29341250

ABSTRACT

A meta-analysis was conducted of studies that reported behavior and chemo/mechanosensory responses by fish, amphibians, and aquatic invertebrates in Cu-containing waters and also reported sufficient water chemistry for calculation of hardness-based and biotic ligand model (BLM)-based water quality criteria (WQC) for Cu. The calculated WQC concentrations were then compared with the corresponding 20% impairment concentrations (IC20) of Cu for those behavior and chemo/mechanosensory responses. The hardness-based acute and chronic WQC for Cu would not have been protective (i.e., the IC20 would have been lower than the WQC) in 33.6 and 26.2%, respectively, of the 107 combined behavior- and chemo/mechanosensory-response cases that also had adequate water chemistry data for BLM-based WQC calculations (32.7% inconclusive). In comparison, the BLM-based acute and chronic WQC for Cu would not have been protective in only 10.3 and 4.7%, respectively, of the same 107 cases (29.9% inconclusive). To improve evaluations of regulatory effectiveness, researchers conducting aquatic Cu toxicity tests should measure and report complete BLM-input water chemistry and bracket the hardness-based and BLM-based WQC concentrations for Cu that would be applicable in their exposure waters. This meta-analysis demonstrates that, overall, the BLM-based WQC for Cu were considerably more protective than the hardness-based WQC for Cu against impairment of behavior and chemo/mechanosensory responses. Environ Toxicol Chem 2018;37:1260-1279. © 2018 SETAC.


Subject(s)
Behavior, Animal , Copper/toxicity , Mechanotransduction, Cellular/drug effects , Water Pollutants, Chemical/toxicity , Water Quality , Animals , Carbon/analysis , Fishes/physiology , Hardness , Invertebrates/drug effects , Invertebrates/physiology , Ligands , Olfactometry , Toxicity Tests
18.
Bull Environ Contam Toxicol ; 100(1): 64-68, 2018 Jan.
Article in English | MEDLINE | ID: mdl-29270647

ABSTRACT

In aquatic toxicology, a toxicity-prediction model is generally deemed acceptable if its predicted median lethal concentrations (LC50 values) or median effect concentrations (EC50 values) are within a factor of 2 of their paired, observed LC50 or EC50 values. However, that rule of thumb is based on results from only two studies: multiple LC50 values for the fathead minnow (Pimephales promelas) exposed to Cu in one type of exposure water, and multiple EC50 values for Daphnia magna exposed to Zn in another type of exposure water. We tested whether the factor-of-2 rule of thumb also is supported in a different dataset in which D. magna were exposed separately to Cd, Cu, Ni, or Zn. Overall, the factor-of-2 rule of thumb appeared to be a good guide to evaluating the acceptability of a toxicity model's underprediction or overprediction of observed LC50 or EC50 values in these acute toxicity tests.


Subject(s)
Metals/toxicity , Toxicity Tests, Acute/methods , Water Pollutants, Chemical/toxicity , Animals , Cyprinidae , Daphnia , Water , Water Pollutants, Chemical/analysis
19.
Environ Sci Technol ; 51(8): 4471-4481, 2017 04 18.
Article in English | MEDLINE | ID: mdl-28329444

ABSTRACT

Multiple metals are usually present in surface waters, sometimes leading to toxicity that currently is difficult to predict due to potentially non-additive mixture toxicity. Previous toxicity tests with Daphnia magna exposed to binary mixtures of Ni combined with Cd, Cu, or Zn demonstrated that Ni and Zn strongly protect against Cd toxicity, but Cu-Ni toxicity is more than additive, and Ni-Zn toxicity is slightly less than additive. To consider multiple metal-metal interactions, we exposed D. magna neonates to Cd, Cu, Ni, or Zn alone and in ternary Cd-Cu-Ni and Cd-Ni-Zn combinations in standard 48 h lethality tests. In these ternary mixtures, two metals were held constant, while the third metal was varied through a series that ranged from nonlethal to lethal concentrations. In Cd-Cu-Ni mixtures, the toxicity was less than additive, additive, or more than additive, depending on the concentration (or ion activity) of the varied metal and the additivity model (concentration-addition or independent-action) used to predict toxicity. In Cd-Ni-Zn mixtures, the toxicity was less than additive or approximately additive, depending on the concentration (or ion activity) of the varied metal but independent of the additivity model. These results demonstrate that complex interactions of potentially competing toxicity-controlling mechanisms can occur in ternary-metal mixtures but might be predicted by mechanistic bioavailability-based toxicity models.


Subject(s)
Daphnia , Metals, Heavy/toxicity , Animals , Biological Availability , Water Pollutants, Chemical , Zinc
20.
Sci Rep ; 7: 40287, 2017 01 10.
Article in English | MEDLINE | ID: mdl-28071758

ABSTRACT

Feral swine are globally known as one of the most destructive invasive vertebrates, damaging native habitats, native plants and animals, agriculture, infrastructure, spreading diseases. There has been little quantification on their disturbance to archaeological sites across a broad landscape. Over 6 years we inspected 293 significant archaeological sites for swine disturbance across a vast area. We found a 42% prevalence of swine disturbance among all sites, with prevalence not distinguishable among prehistoric sites, historic sites, and sites with both components. The areas of disturbance mapped within three historic homestead sites showed 5-26% of total site surface area rooted. Disturbance was not evident upon re-inspection of one of these sites after 18 months, indicating how evidence of disturbance can be obscured in this environment. Thus, our observed 42% prevalence of disturbance should be considered a minimum for disturbance occurring through time. Artifacts depths were <10 cm of the surface at 85% of the sites and <20 cm of the surface for 90% of the sites. Feral swine rooting commonly exceeds 20 cm in depth, especially in soft sandy substrates typical of Florida, making the great majority of the studied sites highly vulnerable to artifact damage or displacement.

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