Evaluating the impact of turbidity, precipitation, and land use on nutrient levels and atrazine concentrations in Illinois surface water as determined by citizen scientists.

The objective of this study was to evaluate the impact of turbidity, precipitation, land use, and five-week variation on nutrient levels and atrazine concentrations across Illinois state. To acquire the greatest number of samples in a cost and time-sensitive manner, data were collected by citizen scientists. Volunteers collected data regarding five water quality metrics: nitrites, nitrates, phosphates, atrazine, and turbidity once per week from April 19 until May 17, 2017. A subset (24 %) of volunteers also collected turbidity measurements. Data regarding precipitation was obtained from the Community Collaborative Rain, Hail and Snow Network (CoCoRaHS), a long-standing grassroots volunteer network of backyard weather observers. Three ordinal regression analyses were performed: one without a blocking effect, a second with week as a blocking effect, and a third with watershed as a blocking effect. In all cases, turbidity was significantly associated with elevated levels of nitrate (Pseudo R2-0.48 to 0.94) and phosphate (Pseudo R2-0.60 to 0.80), while precipitation was significantly associated with elevated levels of nitrate (Pseudo R2-0.25 to 0.35). While analyzing five-week variation, the nitrite and nitrate levels, but not phosphate or atrazine, tended to increase at each site. Further, nitrite and nitrate levels significantly varied between the four land uses - agricultural, urban, suburban, and park. When data were analyzed by the three most well-sampled watersheds, Kankakee, Des Plaines, and Chicago, it was identified that the nutrient levels in the Kankakee and Chicago watersheds were significantly elevated relative to the Des Plaines watershed. Finally, cluster analysis identified that clusters dominated by agricultural land, and to a lesser extent suburban land use, had the most elevated nutrient concentration and the greatest frequency of atrazine hits. Data collected by citizen scientists can provide insight into the geospatial variability of nutrients and agrichemicals and can do so across large geographies.

Chemical Toxicants in Water: A GeoHealth Perspective in the Context of Climate Change.

The editorial focuses on four major themes contextualized in a virtual GeoHealth workshop that occurred from June 14 to 16, 2021. Topics in that workshop included drinking water and chronic chemical exposure, environmental injustice, public health and drinking water policy, and the fate, transport, and human impact of aqueous contaminants in the context of climate change. The intent of the workshop was to further define the field of GeoHealth. This workshop emphasized on chemical toxicants that drive human health. The major calls for action emerged from the workshop include enhancing community engagement, advocating for equity and justice, and training the next generation.

Investigation of Relationships Between the Geospatial Distribution of Cancer Incidence and Estimated Pesticide Use in the U.S. West.

The objective of the study was to evaluate the potential geospatial relationship between agricultural pesticide use and two cancer metrics (pediatric cancer incidence and total cancer incidence) across each of the 11 contiguous states in the Western United States at state and county resolution. The pesticide usage data were collected from the U.S. Geological Survey Pesticide National Synthesis Project database, while cancer data for each state were compiled from the National Cancer Institute State Cancer Profiles. At the state spatial scale, this study identified a significant positive association between the total mass of fumigants and pediatric cancer incidence, and also between the mass of one fumigant in particular, metam, and total cancer incidence (P-value < 0.05). At the county scale, the relationship of all cancer incidence to pesticide usage was evaluated using a multilevel model including pesticide mass and pesticide mass tertiles. Low pediatric cancer rates in many counties precluded this type of evaluation in association with pesticide usage. At the county scale, the multilevel model using fumigant mass, fumigant mass tertiles, county, and state predicted the total cancer incidence (R-squared = 0.95, NSE = 0.91, and Sum of square of residuals [SSR] = 8.22). Moreover, this study identified significant associations between total fumigant mass, high and medium tertiles of fumigant mass, total pesticide mass, and high tertiles of pesticide mass relative to total cancer incidence across counties. Fumigant application rate was shown to be important relative to the incidence of total cancer and pediatric cancer, at both state and county scales.

Assessment of Pediatric Cancer and Its Relationship to Environmental Contaminants: An Ecological Study in Idaho.

The primary aim of this study was to determine the degree to which a multivariable principal component model based on several potentially carcinogenic metals and pesticides could explain the county-level pediatric cancer rates across Idaho. We contend that human exposure to environmental contaminants is one of the reasons for increased pediatric cancer incidence in the United States. Although several studies have been conducted to determine the relationship between environmental contaminants and carcinogenesis among children, research gaps exist in developing a meaningful association between them. For this study, pediatric cancer data was provided by the Cancer Data Registry of Idaho, concentrations of metals and metalloids in groundwater were collected from the Idaho Department of Water Resources, and pesticide use data were collected from the United States Geological Survey. Most environmental variables were significantly intercorrelated at an adjusted P-value <0.01 (97 out of 153 comparisons). Hence, a principal component analysis was employed to summarize those variables to a smaller number of components. An environmental burden index (EBI) was constructed using these principal components, which categorized the environmental burden profiles of counties into low, medium, and high. EBI was significantly associated with pediatric cancer incidence (P-value <0.05). The rate ratio of high EBI profile to low EBI profile for pediatric cancer incidence was estimated as 1.196, with lower and upper confidence intervals of 1.061 and 1.348, respectively. A model was also developed in the study using EBI to estimate the county-level pediatric cancer incidence in Idaho (Nash-Sutcliffe Efficiency = 0.97).

An Unusual Case of Persistent Hypoglycemia in Scrub Typhus.

Acute fever is a common worldwide issue among patients presenting to the emergency department. Main tropical fevers presenting as acute fever are malaria, dengue fever, typhoid, scrub typhus, and leptospirosis. Scrub typhus is a zoonotic disease caused by Orientia tsutsugamushi, which is endemic in many parts of India. Its clinical presentation varies significantly from undifferentiated fever and fever with thrombocytopenia to meningoencephalitis. Persistent hypoglycemia in scrub typhus has not yet been reported. Here we report a case of a 27-year-old male who presented with altered mental status after seven days of scrub typhus diagnosis. Diagnosis of hypoglycemia (random blood sugar of 37 mg/dL) was made at triage. Altered mental status responded to dextrose, but despite meals and treatment, hypoglycemia persisted. The cause for persistent hypoglycemia remained unexplained as most laboratory panels for hypoglycemia were either normal or did not fit into a particular cause.

Extracranial Internal Carotid Aneurysm Manifesting With Tinnitus: A Rare Presentation.

A 19-year-old male presented with a history of pulsatile tinnitus on the left side after he underwent drainage for a tonsillar swelling. He had noticed a painless neck swelling one month ago that was associated with difficulty in swallowing. His physician had made a diagnosis of peritonsillar abscess, and drainage had been performed. After the procedure, the swelling had progressed further, leading to drooling of saliva and disabling tinnitus. When he presented to the emergency, local examination revealed a pulsatile neck swelling with peritonsillar mass. CT angiography/digital subtraction angiography (DSA) of the neck and brain revealed a large aneurysm of the distal cervical segment of the left internal carotid artery (ICA). The patient successfully underwent an urgent open repair. This case highlights the importance of a thorough history and examination in identifying a rare cause of pulsatile tinnitus. A stepwise approach to determine the reason behind tinnitus revealed an underlying ICA aneurysm of the extracranial segment.

A Case of Chorea: A Rare and Unusual Complication of Hyperglycemia.

We present a case of hemichorea in a patient with nonketotic hyperglycemia (NKH), a rare presentation of hyperglycemia. A 55-year-old female with diabetes presented to the emergency department with involuntary bilateral upper and lower limb movements for five days. The patient had a serum glucose level of 358 mg/dL (19.87 mmol/L) and improved after controlling blood sugar levels. When we encounter a case of chorea in the emergency department, high blood sugar levels are an essential underlying reversible etiology to be kept in mind.

Investigation of relationships between fecal contamination, cattle grazing, human recreation, and microbial source tracking markers in a mixed-land-use rangeland watershed.

The United States National Forests are mixed-use lands that support human recreation and cattle grazing. Overuse by humans or cattle, however, can lead to the fecal contamination of local waterways. Until recently, the source of these contaminants was a subject of conjecture; however, microbial source tracking tools have become widely used and are proving to be a valid methodology to identify the contamination source. This study aims to analyze and model the quantity and sources of fecal contamination in the Mink Creek watershed in southeastern Idaho. The U.S. Forest Service Caribou-Targhee National Forest (USFS) manages this watershed. Previous research has indicated that some localities within the watershed exceed US EPA standards for coliform bacteria. In 2019, water samples were collected before livestock began grazing and throughout the spring, summer, and fall after livestock grazing had ended. Fourteen sites were sampled seven times during the field season, allowing the water to be analyzed for total coliforms and E. coli bacteria. Microbial source tracking techniques using Bacteroides bacteria, which are known to live in specific digestive tracks, were used to identify the source of E. coli at each sampling location. The analysis indicated that E. coli counts exceeded state regulatory limits 35% of the time. These exceedances were associated with DNA source tracking markers for humans (58.8%), cattle (5.9%), or both cattle and humans (5.9%). Unknown sources were responsible for the Bacteroides bacteria 29.4% of the time. A statistical model was developed to estimate E. coli using the datasets of microbial source tracking measures, the presence or absence of humans, cattle, the proximity of the sampling date to a holiday, and other seasonal factors. The resulting model showed good performance indices at all the 14 sites based on a K-fold cross-validation scheme (R2 = 0.83 and NSE = 0.69). The results demonstrated that E. coli exceedances have a close association with human recreation and unknown sources and negatively influenced by dissolved oxygen.