The Individual and Synergistic Indexes for Assessments of Heavy Metal Contamination in Global Rivers and Risk: a Review

This article provides an overview of heavy metal contamination in rivers and assessment methods of their contamination and effects. According to literature, rivers with heavy metal contamination in surface water are mainly found in developing countries in Asia, Africa, and Latin America and the Caribbean area, while rivers with heavy metal contamination in sediments are mostly found in Europe. The increase in heavy metal contamination in rivers has led to the adoption of individual and synergistic assessment methods. Individual methods are useful in assessing the contamination and effects for a single heavy metal, while synergistic methods assess the combined contamination and effects of several heavy metals present in surface water and sediments. These two approaches have been commonly used together in recent studies to overcome the limitations of each other and provide a more comprehensive assessment. The developments, equations, advantages, limitations, and future perspectives of these methods are discussed in this review. Calculating indexes are simple, easy-to-implement, and effective methods to provide early alerts for the environmental changes and the adverse impacts on ecosystems and human health. However, calculating indexes still have limitations due to the lack of background concentrations of heavy metals in the study area. Therefore, this issue should be addressed to overcome the limitations of these methods in the future. This review provides a useful reference for future studies on heavy metal contamination in global rivers and the assessment methods for heavy metal contamination and effects

Prevalence and risk factors for milk allergy overdiagnosis in the BEEP trial cohort.

BACKGROUND: Cow's milk allergy (CMA) overdiagnosis in young children appears to be increasing and has not been well characterised. We used a clinical trial population to characterise CMA overdiagnosis and identify individual-level and primary care practice-level risk factors. METHODS: We analysed data from 1394 children born in England in 2014-2016 (BEEP trial, ISRCTN21528841). Participants underwent formal CMA diagnosis at ≤2 years. CMA overdiagnosis was defined in three separate ways: parent-reported milk reaction; primary care record of milk hypersensitivity symptoms; and primary care record of low-allergy formula prescription. RESULTS: CMA was formally diagnosed in 19 (1.4%) participants. CMA overdiagnosis was common: 16.1% had parent-reported cow's milk hypersensitivity, 11.3% primary care recorded milk hypersensitivity and 8.7% had low-allergy formula prescription. Symptoms attributed to cow's milk hypersensitivity in participants without CMA were commonly gastrointestinal and reported from a median age of 49 days. Low-allergy formula prescriptions in participants without CMA lasted a median of 10 months (interquartile range 1, 16); the estimated volume consumed was a median of 272 litres (26, 448). Risk factors for CMA overdiagnosis were high practice-based low-allergy formula prescribing in the previous year and maternal report of antibiotic prescription during pregnancy. Exclusive formula feeding from birth was associated with increased low-allergy formula prescription. There was no evidence that practice prescribing of paediatric adrenaline auto-injectors or anti-reflux medications, or maternal features such as anxiety, age, parity and socioeconomic status were associated with CMA overdiagnosis. CONCLUSION: CMA overdiagnosis is common in early infancy. Risk factors include high primary care practice-based low-allergy formula prescribing and maternal report of antibiotic prescription during pregnancy

Oxygen sensing by HIF hydroxylases.

The transcription factor HIF (hypoxia-inducible factor) has a central role in oxygen homeostasis in animals ranging from nematode worms to man. Recent studies have shown that this factor is regulated by an unprecedented signalling mechanism that involves post-translational hydroxylation. This hydroxylation is catalysed by a set of non-haem, Fe2+-dependent enzymes that belong to the 2-oxoglutarate-dependent-oxygenase superfamily. The absolute requirement of these enzymes for molecular oxygen has provided new insights into the way cells sense oxygen