Open Access. Powered by Scholars. Published by Universities.®
Pharmacology, Toxicology and Environmental Health Commons™
Open Access. Powered by Scholars. Published by Universities.®
- Discipline
-
- Environmental Health (48)
- Medicine and Health Sciences (26)
- Public Health (26)
- Epidemiology (16)
- Toxicology (15)
-
- Physical Sciences and Mathematics (13)
- Chemistry (9)
- Analytical Chemistry (6)
- Biochemistry, Biophysics, and Structural Biology (5)
- Molecular Biology (5)
- Pharmacology (4)
- Environmental Sciences (3)
- Occupational Health and Industrial Hygiene (3)
- Cell Biology (2)
- Cell and Developmental Biology (2)
- Engineering (2)
- Nanoscience and Nanotechnology (2)
- Other Chemistry (2)
- Social and Behavioral Sciences (2)
- Atmospheric Sciences (1)
- Biology (1)
- Biostatistics (1)
- Ecology and Evolutionary Biology (1)
- Immunology and Infectious Disease (1)
- Immunology of Infectious Disease (1)
- Microbiology (1)
- Natural Resources Management and Policy (1)
- Neuroscience and Neurobiology (1)
- Keyword
-
- Cytochrome P-450 (8)
- Air (4)
- Lead (4)
- Mice as laboratory animals (4)
- Polychlorinated biphenyls (4)
-
- Trace elements (4)
- Air quality (3)
- Cardiovascular system (3)
- Cytochrome P450 (3)
- Fertilization in vitro (3)
- Lungs (3)
- Mohawk Indians (3)
- Naphthalene (3)
- Respiratory organs (3)
- Antibiotics (2)
- Arsenic (2)
- Atmospheric aerosols (2)
- Behavioral toxicology (2)
- Bioactivation (2)
- Biological monitoring (2)
- Biomonitoring (2)
- Blood (2)
- Breast (2)
- CYP2A13 (2)
- Cardiovascular Diseases (2)
- Chemical mechanical planarization (2)
- Cytochrome P-450 Enzyme System (2)
- Drinking water (2)
- Environmental health (2)
- Environmental monitoring (2)
Articles 31 - 60 of 61
Full-Text Articles in Pharmacology, Toxicology and Environmental Health
Military Contamination And Persistent Organochlorine Pesticide Exposure Among Alaska Natives, Samuel Byrne
Military Contamination And Persistent Organochlorine Pesticide Exposure Among Alaska Natives, Samuel Byrne
Legacy Theses & Dissertations (2009 - 2024)
St. Lawrence Island Alaska is located in the Bering Sea, only 36 miles from Siberia. The island is home to approximately 1600 Siberian Yupik residents, who rely heavily on subsistence hunting and gathering. There are two formerly used defense (FUD) sites on the island, one of which has been the subject of an approximate $110 million cleanup effort. Environmental monitoring suggests localized soil and watershed contamination with PCBs, organochlorine pesticides and heavy metals. Previous research suggests the site may be a source of PCB exposure for local residents. The primary aim of the study was to determine whether subsistence activities …
Paternal Occupational Pesticide Exposure And Neural Tube Defects In The National Birth Defects Prevention Study, Stacy Marie Pettigrew
Paternal Occupational Pesticide Exposure And Neural Tube Defects In The National Birth Defects Prevention Study, Stacy Marie Pettigrew
Legacy Theses & Dissertations (2009 - 2024)
ABSTRACT
Sleep Duration And Diabetes In An Adult Population Of Rural Upstate New York, Tarak Shrestha
Sleep Duration And Diabetes In An Adult Population Of Rural Upstate New York, Tarak Shrestha
Legacy Theses & Dissertations (2009 - 2024)
Introduction: Within the past five decades, there has been a rapid increase in the number of diabetic cases in the US. The number of diabetic cases increased from 1.5 million in 1959 to 25.8 million in 2011. Around the same time period, the average sleep duration per night decreased from 8 hours to 6.9 hours.
Study Of Protective Role Of Cytochrome P450s In Inflammatory Bowel Disease Using Cprlow Mouse Model, Xiaoyu Fan
Study Of Protective Role Of Cytochrome P450s In Inflammatory Bowel Disease Using Cprlow Mouse Model, Xiaoyu Fan
Legacy Theses & Dissertations (2009 - 2024)
Glucocorticoids (GCs) are potent regulatory factors for inflammation. The synthesis of GCs involves several cytochrome P450 enzymes, such as mitochondrial CYP11A1, CYP11B1, and microsomal CYP21. Previous studies have indicated that the GCs, including those released from adrenal glands, and those synthesized in extra-adrenal tissues, such as intestine, exert inhibitory effects on inflammatory bowel disease (IBD). In a previous study using an intestinal epithelium (IE)-specific P450 reductase (CPR) knockout (IE-Cpr-null) mouse model, the results suggested that the intestinal P450s had a protective role in DSS-induced acute colitis. In this study, using a hypomorphic CPR mouse model (Cprlow), which presents a global …
Atrazine In Maternal Drinking Water Supply Below The Federal Maximum Contaminant Level And Risk Of Preterm Birth, Small For Gestational Age, Cryptorchidism And Hypospadias, Daniel Rice
Legacy Theses & Dissertations (2009 - 2024)
The prevalence of preterm birth, small for gestational age (SGA), and hypospadias has been increasing for several decades in the U.S resulting in significant morbidity and mortality and direct costs to society. Drinking water provides a mechanism for prolonged chronic exposure to environmental contaminants but is one of the least assessed environmental exposures in pregnancy and birth outcomes. To test the hypothesis that maternal exposure to atrazine through drinking water during pregnancy, or one or more trimesters of gestation, is associated with an increased risk of preterm birth, small for gestational age, cryptorchidism and hypospadias a retrospective cohort study was …
Improving The Microbial Source Tracking Toolbox : Evaluating The Use Of Selective Enrichments And Artificial Sweeteners In A Multi-Tiered Approach, Stacey A. Helming
Improving The Microbial Source Tracking Toolbox : Evaluating The Use Of Selective Enrichments And Artificial Sweeteners In A Multi-Tiered Approach, Stacey A. Helming
Legacy Theses & Dissertations (2009 - 2024)
Microbial contamination of surface waters is a public health concern world-wide, with non-point source fecal input contributing to millions of cases of waterborne illness annually. Numerous techniques have been proposed to monitor for non-point source fecal contamination, but few studies have explored the correlation of multiple chemical and microbial fecal source tracking markers in ambient waters. Therefore, the purpose of these studies was to evaluate the use of multiple "ideal" markers of fecal contamination and improve upon any analytical techniques required to identify species-specific fecal contamination in surface waters. The use of selective enrichments to improve the sensitivity of end-point …
Symbiotic Associations Between Vibrio Cholerae And Copepods And Their Potential Public Health Impact, Gretchen Boria Pérez
Symbiotic Associations Between Vibrio Cholerae And Copepods And Their Potential Public Health Impact, Gretchen Boria Pérez
Legacy Theses & Dissertations (2009 - 2024)
Vibrio cholerae O1 concentrate in copepods by attaching to their chitinous exoskeleton and gut, making these planktonic crustaceans participants in the spread of cholera in marine and estuarine environments. The role of the symbiosis in the spread of gastrointestinal disease caused by non-O1 serotypes has not been well-studied in fresh water systems. The goal of these studies was to determine whether symbiotic association of V. cholerae with copepods affects virulence of hemolysin/cytolysin toxin, suspected in V. cholerae non-O1 related morbidity. The reverse-transcription-polymerase chain reaction was used to evaluate the relative transcriptional response of hlyA, encoding hemolysin, by a non-O1 strain …
Perfluorinated Compounds, Thyroid Function, And Neuropsychological Status In Older Residents Of Upper Hudson River Communities, Srishti Shrestha
Perfluorinated Compounds, Thyroid Function, And Neuropsychological Status In Older Residents Of Upper Hudson River Communities, Srishti Shrestha
Legacy Theses & Dissertations (2009 - 2024)
Perfluorinated compounds (PFCs) are widespread in the environment. Minimal data exist regarding the neurotoxicity and thyroid disruptive property of PFCs in aging populations and the possible mediating effects of thyroid hormones (THs). In this study, we assessed associations among PFCs, thyroid function, and neuropsychological status, and determined if the neurotoxic effects of PFCs are mediated by changes in THs in an aging population. We measured perfluorooctanoic acid (PFOA), perfluorooctane sulfonate (PFOS), thyroid stimulating hormone (TSH), total thyroxine (T4), free T4 (fT4), and total triiodothyronine (T3) in serum and performed neuropsychological tests in men and women aged 55-74 years and living …
Exposure Assessment And Risk Management Of Engineered Nanoparticles : Investigation In Semiconductor Wafer Processing, Michele Shepard
Exposure Assessment And Risk Management Of Engineered Nanoparticles : Investigation In Semiconductor Wafer Processing, Michele Shepard
Legacy Theses & Dissertations (2009 - 2024)
Engineered nanomaterials (ENMs) are currently used in hundreds of commercial products and industrial processes, with more applications being investigated. Nanomaterials have unique properties that differ from bulk materials. While these properties may enable technological advancements, the potential risks of ENMs to people and the environment are not yet fully understood. Certain low solubility nanoparticles are more toxic than their bulk material, such that existing occupational exposure limits may not be sufficiently protective for workers. Risk assessments are currently challenging due to gaps in data on the numerous emerging materials and applications as well as method uncertainties and limitations.
Exposure To Persistent Organic Pollutants And Metabolic Diseases, Zafar Zayirovich Aminov
Exposure To Persistent Organic Pollutants And Metabolic Diseases, Zafar Zayirovich Aminov
Legacy Theses & Dissertations (2009 - 2024)
Background: The metabolic syndrome (MetS) is a group of diseases that tend to occur together, including diabetes, hypertension, central obesity, cardiovascular disease and hyperlipidemia. Exposure to persistent organic pollutants (POPs) such as polychlorinated biphenyls (PCBs) and organochlorine pesticides (OCPs) have been associated with increased risk of development of several of the components of the MetS.
Development And Assessment Of Analytical Methods For Monitoring Current And Historical Exposures To Manganese : Blood, Urine, And Teeth, Meredith Lyn Praamsma
Development And Assessment Of Analytical Methods For Monitoring Current And Historical Exposures To Manganese : Blood, Urine, And Teeth, Meredith Lyn Praamsma
Legacy Theses & Dissertations (2009 - 2024)
Manganese, as an essential trace element, is a cofactor in numerous enzymes that aid in bone growth, cholesterol synthesis, and carbohydrate metabolism. Manganese can become toxic with overexposure, potentially leading to neurodegenerative effects and the disease manganism. Manganese concentrations in blood and urine have been widely used in monitoring current exposure and now there is interest in using manganese concentrations in teeth for monitoring historical exposure, especially in utero and in early childhood.
Function And Regulation Of Intestinal P450 Enzymes : Insights From Conditional Cytochrome P450 Reductase Knockout Mouse Models, Yi Zhu
Legacy Theses & Dissertations (2009 - 2024)
The overall goal of this thesis work was to investigate the function and regulation of intestinal P450 enzymes (P450s). The central hypotheses are that 1) small intestinal (SI) P450s play an important role in the first-pass clearance of oral drugs and in bioactivation of chemicals that cause intestinal toxicity, 2) endogenous regulatory compounds produced by intestinal P450s are important for protection against chemical-induced colon inflammation, and 3) there is a cross talk between the liver and the SI that helps to maintain the overall xenobiotic-metabolism capacity of the digestive tract.
Impact Of Black Carbon On Global Climate : A Half-Century Of Arctic Black Carbon -- Trends And Sources, Anthony Michael Dejulio
Impact Of Black Carbon On Global Climate : A Half-Century Of Arctic Black Carbon -- Trends And Sources, Anthony Michael Dejulio
Legacy Theses & Dissertations (2009 - 2024)
Abstract
Role Of P450 Enzymes In Tobacco Dependence And Lung Tumorigenesis, Lei Li
Role Of P450 Enzymes In Tobacco Dependence And Lung Tumorigenesis, Lei Li
Legacy Theses & Dissertations (2009 - 2024)
The overall aim of this study is to better define the roles of P450 enzymes, particularly those in the CYP2A, 2B, and 2F gene subfamilies, in the metabolism and actions of tobacco-related chemicals. Tobacco smoke contains numerous compounds that are deleterious to health, including the primary addictive component nicotine and procarcinogenic compounds, such as naphthalene (NA) and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK). Our main hypotheses are i) that CYP2A and 2B enzymes are largely responsible for nicotine metabolism, and they can impact nicotine dependence; and ii) that CYP2A, 2B, and 2F enzymes play important and tissue-specific roles in NA and NNK bioactivation, leading …
Assessment Of Human Exposure To Perchlorate And Perfluoroalkyl Substances In The United States : Biomonitoring And Environmental Monitoring Approaches, Qian Wu
Legacy Theses & Dissertations (2009 - 2024)
Perchlorate is an oxidant in solid fuels and explosives and is produced in large quantities worldwide. Perchlorate is a ubiquitous environmental contaminant and is present in water, food, indoor environment and humans. Human exposure to perchlorate is a concern due to its ability to disrupt the thyroid gland functions.
Short-Term Associations Between Pm2.5, Black Carbon, Delta-C, And Cardiovascular Diseases In A Large Developing Megacity, Daniel Malashock
Short-Term Associations Between Pm2.5, Black Carbon, Delta-C, And Cardiovascular Diseases In A Large Developing Megacity, Daniel Malashock
Legacy Theses & Dissertations (2009 - 2024)
Introduction: Association between ambient air pollution and cardiovascular disease (CVD) have been demonstrated by many epidemiological studies in developed countries, however few studies have been performed in developing countries of Asia.
Trace Element Analysis Of Environmental And Clinical Materials Using Novel Instrumentation Based On X-Ray Fluorescence Spectrometry : New Capabilities For Public Health Laboratories, Kathryn G. Mcintosh
Trace Element Analysis Of Environmental And Clinical Materials Using Novel Instrumentation Based On X-Ray Fluorescence Spectrometry : New Capabilities For Public Health Laboratories, Kathryn G. Mcintosh
Legacy Theses & Dissertations (2009 - 2024)
X-ray fluorescence (XRF) spectrometry is a well-established analytical technique for determining the elemental content of many different materials. XRF has long been used for public health applications, particularly for identifying lead-based paint hazards. The primary advantage of XRF over other atomic spectrometric techniques is that it is nondestructive. In addition, little sample preparation is required, so results are obtained rapidly and at low cost. The principal aim of this study was to characterize the utility and reliability of current XRF instrumentation for use in the environmental health sciences. Interest in the use of XRF for detecting lead in children's toys …
Occupational Exposure And Risk Of Skin Cancer In A Multinational European Study, Simona Surdu
Occupational Exposure And Risk Of Skin Cancer In A Multinational European Study, Simona Surdu
Legacy Theses & Dissertations (2009 - 2024)
Non-melanoma skin cancers (NMSC) comprise more than one third of all cancers, and are increasing worldwide. The most common NMSC are Basal Cell Carcinoma (BCC) and Squamous Cell Carcinoma (SCC). Studies on humans and animals suggest that sunlight and arsenic play important roles in the pathogenesis of these skin malignancies. However, the number of epidemiological studies focusing on NMSC in workers exposed to ultraviolet (UV) radiation or airborne arsenic is limited, and the findings are contradictory.
Association Between Chemical Constituents Of Particulate Matter And Cardiovascular And Respiratory Morbidities In Nys, Rena Jones
Legacy Theses & Dissertations (2009 - 2024)
Improved understanding of health risks from short- and long-term exposure to fine particulate matter (PM2.5) constituents may explain seasonal and geographic heterogeneity in PM2.5-health associations and inform control efforts targeting PM sources. Few studies have examined PM species health effects; most have been limited by their exposure assessments and modeling approaches. The goals of this project were to improve the PM exposure assessment and explore relationships between PM2.5 species and health in acute and chronic contexts.
Evaluation Of The Short- And Long- Term Drinking Water Sustainability Programs For Point Water Sources And Public Water Supplies (Pws) In Developing Countries : Case Study Of Uganda, Shedrack R. Nayebare
Evaluation Of The Short- And Long- Term Drinking Water Sustainability Programs For Point Water Sources And Public Water Supplies (Pws) In Developing Countries : Case Study Of Uganda, Shedrack R. Nayebare
Legacy Theses & Dissertations (2009 - 2024)
Providing quantity and quality potable water in Uganda and other developing countries is still significantly problematic. This project aimed at identifying and prioritizing possible actions on how sustainable and high quality potable water in Uganda's water supply systems could be improved. A review of both the current water supply systems and Ugandan government programs was completed in an effort to describe the existing state of Uganda's water supply. Aspects of quantity, quality, treatment methods, infrastructure, storage and distribution of water for the different water systems were assessed. These characteristics were compared to water supply systems and regulations in the U.S., …
Seafood Consumption And Use Of Asian Herbal Preparation As A Source Of Exposure To Multiple Trace Elements In The Study Of Metals And Assisted Reproductive Technologies (Smart), Dongsul Kim
Legacy Theses & Dissertations (2009 - 2024)
As, Cd, Cs, Hg, Pb, and Zn may be associated with in vitro fertilization (IVF) outcomes. Seafood and Asian herbal preparations are identified as sources of exposure to these essential and non-essential trace elements in humans. The goal of the study is to assess associations between seafood consumption and the use of Asian herbal preparations and levels of essential and non-essential trace elements in biologic specimens collected from couples undergoing IVF. Fifty-nine couples completing a first IVF cycle at the University of California, San Francisco (UCSF) Center for Reproductive Health were recruited to participate in the Study of Metals and …
Gene And Environment Interactions Modulate Immune System Influences On Social Behavior, Yubin Zhang
Gene And Environment Interactions Modulate Immune System Influences On Social Behavior, Yubin Zhang
Legacy Theses & Dissertations (2009 - 2024)
Autism is a neurodevelopmental disorder with unknown etiology, affecting about 1 in 110 children in the US. Here, we show that developmental exposure to anti-brain Abs impaired mouse social behaviors. BTBR mice, a mouse strain with high serum anti-brain Abs and behaviors that resemble autism, have more activated splenic B cells, CD4+ T cells (Th1, Th2 and Th17 subsets), and CD4+ T cells with expression of Vb6 chains than B6 mice (the control H-2 identical strain). Elevated numbers of activated (CD25+) CD4+Vb6+ cells also were detected in thymic preparations. All of the immunological and behavioral parameters of BTBR mice were …
The Role Of Androstane Neurosteroids In Alcohol-Mediated Social Behavior, Jason J. Paris
The Role Of Androstane Neurosteroids In Alcohol-Mediated Social Behavior, Jason J. Paris
Legacy Theses & Dissertations (2009 - 2024)
Androgenic steroids, such as testosterone, may influence the propensity for aggression in both people and animals. Some of testosterone's effects on aggression may be due, in part, to its metabolic products that are 5á-reduced and 3á-hydroxylated to form, 3á-androstanediol (3á-diol), which can also enhance aggression in mice. Notably, alcohol (EtOH) consumption facilitates aggression in people and animals, particularly among those predisposed to act aggressively. In rats, EtOH can increase 3á-diol in prefrontal cortex, which may facilitate aggression. The present work aimed to elucidate the role of 3á-diol for EtOH-enhanced aggression. We hypothesized that EtOH would enhance inter-male aggression, social dominance, …
The Nasal Toxicity Of The Herbicide 2,6-Dichlorobenzonitrile : Mechanisms And Biomarkers, Fang Xie
The Nasal Toxicity Of The Herbicide 2,6-Dichlorobenzonitrile : Mechanisms And Biomarkers, Fang Xie
Legacy Theses & Dissertations (2009 - 2024)
The overall goal of this study is to investigate mechanisms of the potent nasal specific toxicity of the herbicide 2,6-dichlorobenzonitrile (DCBN) in rodents, and to determine whether DCBN could induce similar nasal toxicity in humans. The central hypotheses are 1) that the nasal specific toxicity of DCBN in rodents is mediated by its electrophilic intermediates that are formed through metabolic activation catalyzed by target tissue cytochrome P450 enzymes (P450) and can interfere with stem cell regeneration and differentiation in the olfactory epithelium (OE); and 2) that human nasal tissues are also capable of catalyzing bioactivation of DCBN. The specific aims …
Regulation Of The Aryl Hydrocarbon Receptor And The Signal Transducer And Activator Of Transcription 1 By Long-Term Estrogen Exposure In Breast Carcinoma Cells, Neal Englert
Legacy Theses & Dissertations (2009 - 2024)
The risk of developing breast cancer is known to be associated with a woman's lifetime exposure to estrogens, both endogenous and exogenous. Increased exposure to estrogens stimulates cellular proliferation, which is a widely accepted theory of estrogen receptor positive mammary carcinogenesis. The molecular mechanisms of gene expression regulation in response to long-term estrogen exposure (LTEE) of MCF-7 breast cancer cells were addressed in this study, with a focus on the aryl hydrocarbon receptor (AHR) and signal transducer and activator of transcription 1 (STAT1).
Retrieval Of Atmospheric Elemental Carbon Records Using Lake Sediments : Implications In Radiative Forcing, Tanveer Ahmed
Retrieval Of Atmospheric Elemental Carbon Records Using Lake Sediments : Implications In Radiative Forcing, Tanveer Ahmed
Legacy Theses & Dissertations (2009 - 2024)
Elemental or black carbon (EC or BC) aerosols produced during incomplete combustion strongly absorb solar radiation and contribute to global warming, and cause cardiopulmonary disease. Long-term atmospheric EC measurements, [EC]atm, are needed to validate global climate models to estimate the impact of EC on earth's temperature. Such data is sparse.
Preparation And Application Of Transgenic And Knockout Mouse Models For Studies On Cytochrome P450 Functions, Yuan Wei
Legacy Theses & Dissertations (2009 - 2024)
The overall objective of this dissertation is to study the in vivo function of microsomal cytochrome P450 monooxygenases (P450s), which metabolize numerous drugs, chemical carcinogens, environmental pollutants, as well as endogenous signaling molecules such as steroid hormones and eicosanoids. The major research tool of this study involves the development of transgenic and knockout mouse models. The specific aims are 1) to study the in vivo function of NADPH-cytochrome P450 reductase (CPR) and CPR-dependent enzymes using a mouse model with a reversible hypomorphic Cpr gene; 2) to study the in vivo function of CYP2A13 with a CYP2A13- transgenic model; and 3) …
Arsenic Speciation Analysis Of Biological Fluids : A Study Of Liquid Chromatography Coupled To Analytical Atomic Spectrometric Instrumentation, Kanna Ito
Legacy Theses & Dissertations (2009 - 2024)
Arsenic exists as many different chemical forms including inorganic, methylated and dietary species. The toxicity of these species varies: some are highly toxic and can cause adverse health effects in many parts of the body; others are considered relatively non-toxic. Monitoring arsenic exposure is usually accomplished by its direct measurement in biological fluids. Urine is the specimen of choice for assessing arsenic exposure, because of its short biological half-life in blood. There have been very few studies of arsenic species in blood, yet such research can provide valuable information on arsenic distribution and its metabolism in the body.
Multiple Antibiotic Resistant Staphylococcus Spp. In Environmental Settings, Stephen Shost
Multiple Antibiotic Resistant Staphylococcus Spp. In Environmental Settings, Stephen Shost
Legacy Theses & Dissertations (2009 - 2024)
Ninety staphylococci carrying the mecA gene, including 17 strains of methicillin-resistant Staphylococcus aureus (MRSA), were isolated from environmental settings within New York State. Waterborne staphylococci harboring mecA were isolated from multiple sources: the Hudson River near a combined sewage overflow; urban streams; freshwater and marine beaches; a swimming pool; swimming pool decks; combined sewage; as well as wastewater treatment plant (WWTP) primary sewage influent, mixed liquor, aeration water, and final (unchlorinated) effluent. Environmental MRSA strains were isolated from beach water (n=3); swimming pool deck water (n=1); Hudson River water (n=2); combined sewage (n=3); as well as wastewater treatment plant mixed …
Biomonitoring Of Perfluorochemicals In Human Blood, Breast Milk, Saliva, And Urine, Lin Tao
Biomonitoring Of Perfluorochemicals In Human Blood, Breast Milk, Saliva, And Urine, Lin Tao
Legacy Theses & Dissertations (2009 - 2024)
Perfluorochemicals (PFCs) have been used as surfactants and surface protectors in a large number of consumer products. PFCs have been reported to elicit adverse health effects in laboratory animals and humans, and have been detected in foodstuffs and in human bodies. In this dissertation, analytical methods were developed for the determination of trace levels of PFCs in human blood, dried blood spot, breast milk, saliva, and urine. An assessment of human exposure to PFCs was performed by analyzing human specimens collected from the United States and several Asian countries. Blood, breast milk, and dried blood spots were found to be …