Large Regional Variations Research Articles

Grain mineral concentrations and yield of wheat grown under organic and conventional management

AbstractOn the low‐P soils in southeastern Australia, organic crops differ from conventional ones primarily in the use of relatively insoluble, as opposed to soluble, P fertilisers and in the non‐use of herbicides. As organic management, particularly elimination of soluble fertilisers, is often claimed to enhance grain mineral concentrations, we examined grain from wheat on paired organic and conventional farms in two sets of experiments: (1) four pairs of commercial crops (1991–1993); and (2) fertiliser experiments on one farm pair where nil fertiliser was compared with 40 kg ha−1 of P as either relatively insoluble reactive phosphate rock or more soluble superphosphate (1991 and 1992). All wheat was grown following a 2–6 year legume‐based pasture phase. Both conventional management and the superphosphate treatment greatly increased yields but reduced colonisation by mycorrhizal fungi. While only minor variations occurred in grain N, K, Mg, Ca, S and Fe concentrations, conventional grain had lower Zn and Cu but higher Mn and P than organic grain. These differences were ascribed to: soluble P fertilisers increasing P uptake but reducing mycorrhizal colonisation and thereby reducing Zn uptake and enhancing Mn uptake; dilution of Cu in heavier crops; and past lime applications on the organic farm decreasing Mn availability. These variations in grain minerals had nutritional implications primarily favouring the organic grain; however, organic management and, specifically, elimination of soluble fertilisers did not induce dramatic increases in grain mineral concentrations. In addition, organic management was coupled with yield reductions of 17–84 per cent due to P limitation and weeds. The impact of large regional variations in the characteristics of organic and conventional systems on the general applicability of the results from this study and other similar studies is discussed. Copyright © 2004 Society of Chemical Industry

Dual-season mapping of wetland inundation and vegetation for the central Amazon basin

Wetland extent was mapped for the central Amazon region, using mosaicked L-band synthetic aperture radar (SAR) imagery acquired by the Japanese Earth Resources Satellite-1. For the wetland portion of the 18×8° study area, dual-season radar mosaics were used to map inundation extent and vegetation under both low-water and high-water conditions at 100-m resolution, producing the first high-resolution wetlands map for the region. Thematic accuracy of the mapping was assessed using high-resolution digital videography acquired during two aerial surveys of the Brazilian Amazon. A polygon-based segmentation and clustering was used to delineate wetland extent with an accuracy of 95%. A pixel-based classifier was used to map wetland vegetation and flooding state based on backscattering coefficients of two-season class combinations. Producer's accuracy for flooded and nonflooded forest classes ranged from 78% to 91%, with lower accuracy (63–65%) for flooded herbaceous vegetation. Seventeen percent of the study quadrat was occupied by wetlands, which were 96% inundated at high water and 26% inundated at low water. Flooded forest constituted nearly 70% of the entire wetland area at high water, but there are large regional variations in the proportions of wetland habitats. The SAR-based mapping provides a basis for improved estimates of the contribution of wetlands to biogeochemical and hydrological processes in the Amazon basin, a key question in the Large-Scale Biosphere–Atmosphere Experiment in Amazônia.

Blood pressure is insufficiently controlled in European patients with established coronary heart disease

Elevated blood pressure is associated with an impaired prognosis in patients with established coronary heart disease. Adequate blood pressure control is therefore of utmost importance. We report on two successive European surveys that evaluated whether the goals given in recommendations on secondary prevention are achieved. The first European Action on Secondary Prevention through Intervention to Reduce Events (EUROASPIRE I) survey was conducted during 1995-1996 in 21 hospitals in nine European countries. The second survey (EUROASPIRE II) was conducted during 1999-2000 in 47 hospitals (including 20 hospitals that participated in EUROASPIRE I) in 15 Europeans countries. Consecutive patients (aged < 71 years) were identified from hospital records after coronary artery bypass grafting, percutaneous coronary intervention, myocardial infarction, or myocardial ischaemia. Patients were invited for an interview and examination at least 6 months after hospitalization. During the interview, blood pressure was measured in a standardized fashion. Systolic blood pressure >/= 140 mmHg and/or a diastolic blood pressure >/= 90 mmHg were considered as elevated blood pressure. EUROASPIRE II provides a more comprehensive view on the actual management of patients with established coronary disease. Therefore, we decided to concentrate mainly on the EUROASPIRE II data, and to use EUROASPIRE I for the evaluation of time trends. In EUROASPIRE II, 5556 patients were interviewed, and 51% were diagnosed with elevated blood pressure. Large regional variations in the prevalence of elevated blood pressure were observed, with values ranging from 37 to 64%. Twenty-five per cent (1401) of patients were on a diet to reduce blood pressure, and among these 61% had elevated blood pressure. The prevalence of elevated blood pressure among the 4827 (87%) patients taking blood pressure-lowering medication (which was not necessarily taken as an antihypertensive treatment) was 51%. Patients with elevated blood pressure were more likely to be diabetic, hypercholesterolemic, and obese than normotensive patients. The proportion of patients who reported being aware of their hypertensive status was somewhat higher in EUROASPIRE II than in EUROASPIRE I (71 versus 67%), and the use of blood pressure-lowering medication was intensified (91 versus 85%). However, these changes were not accompanied by a decrease in the prevalence of elevated blood pressure (54 versus 55% in centres that participated in both surveys). During 1995-2000 the prevalence of elevated blood pressure in patients with established coronary heart disease remained at an unacceptably high level. Throughout Europe, still about half of coronary patients require more intensive blood pressure management.

Cadmium contents of oats (Avena sativa L.) in official variety, organic cultivation, and nitrogen fertilization trials during 1997-1999.

The cadmium (Cd) contents of oats (Avena sativa L.) in Finland were examined over a 3 year period in three types of trials: official variety, organic vs conventional cultivation, and nitrogen fertilization trials. Large seasonal and regional variations were found in the Cd concentrations. In official variety trials, the mean Cd contents in 1997, 1998, and 1999 were 0.046, 0.029, and 0.052 mg kg(-1) dry weight (dw), respectively, ranging from 0.008 to 0.120 mg kg(-1) dw. The concentrations were generally well below the maximum permitted level of 0.100 mg kg(-1) fresh weight. No significant differences were found between the organic and the conventional cultivation techniques. Nitrogen (N) fertilization increased the Cd contents of oats especially at high nitrogen rates (160 kg N hectare(-1) (ha)). Significant cultivar differences (p < 0.001) were determined in all trials. Cultivars Salo and Kolbu had consistently higher contents, and Belinda and Roope had lower Cd contents among the different growing conditions. Hence, it is possible to cultivate and develop oat cultivars less likely to accumulate Cd.

SST availabilities of satellite infrared and microwave measurements

To investigate the feasibility and methodology of new generation sea surface temperature (SST) maps that combine various satellite measurements, we have quantitatively evaluated SST availabilities of NOAA AVHRR (National Oceanic and Atmospheric Administration, Advanced Very High Resolution Radiometer), GMS S-VISSR (Geostationary Meteorological Satellite, Stretched-Visible Infrared Spin Scan Radiometer) and TRMM MI (Tropical Rainfall Measuring Mission, Microwave Imager: TMI), during the one-year period from October 1999 to September 2000. The advantage of satellite microwave SST measurements is the ability to penetrate the clouds that contaminate satellite infrared measurements. Daily SST availabilities were calculated in the overlapping coverage from 20°N to 38°N and 120°E to 160°E. The annual-mean SST availabilities of AVHRR, S-VISSR and TMI are 48%, 56% and 78%, respectively. There are large seasonal variations in the availabilities of infrared measurements. The latitude-time plots of one-degree zonal mean SST availabilities of S-VISSR and TMI in the region from 38°S to 38°N and 80°E to 160°W show significant zonal variations, which are influenced by the atmospheric circulation such as the Subtropical High and the Intertropical Convergence Zone. The SST availabilities of S-VISSR and TMI in the five selected regions have large regional variations, ranging from 35% to 74% and 62% to 88% for S-VISSR and TMI, respectively. The present statistical analyses of SST availabilities in the infrared and microwave measurements indicate that 1) a daily cloud-free high-spatial resolution may be achieved by merging various SST measurements since their deficiencies compensate each other, and 2) nevertheless, it is necessary to take account of the seasonal and regional variations of SST availabilities of different satellite sensors for the development of merging technology.

Sardine slipping during purse-seining off northern Portugal

Observations aboard purse-seiners demonstrated that deliberate lowering of the net to allow pelagic fish to escape (“slipping”) was frequent off northern Portugal during the second semester of 2001. Some slipping occurred in 25 of 30 trips observed, and the quantities slipped were significantly higher when the net was set on dense echo-sounder marks. During the 12 weeks of the study, the sampled fleet (nine vessels) landed 2196 t and deliberately released an estimated 4979 t (CV 33.6%). More than 95% of the total catch was sardine. Data provided by the skippers in the absence of shipboard observers led to considerably lower estimates of slipped quantities. The main reason for slipping was daily quota limitations, but illegal size and mixture with unmarketable bycatch were also reported. These results demonstrate the existence and potential magnitude of slipping, but indications of large seasonal and regional variations make extrapolations for the entire fishery impractical.

Observed climate variability and change

Chapter 2 emphasises change against a background of variability. The certainty of conclusions that can be drawn about climate from observations depends critically on the availability of accurate, complete and consistent series of observations. For many variables important in documenting, detecting, and attributing climate change, data are still not good enough for really firm conclusions to be reached. This especially applies to global trends in variables that have large regional variations, such as pre-

Using Administrative Data to Improve Compliance with Mandatory State Event Reporting

The New York Patient Occurrence and Tracking System (NYPORTS) is a mandatory adverse event reporting system that was redesigned in 1998. Analysis of the first full year of its use showed large regional and hospital variation in reporting frequency not due to hospital or case mix differences. In early 2001, New York State mandated that all hospitals conduct retrospective review for unreported adverse incidents for the previous 2 years. Hospitals could submit previously unreported incidents within a defined window without penalty. The hospital used an ICD-9-CM (International Classification of Diseases, Ninth Revision, Clinical Modification) analysis to screen for missed NYPORTS cases, to assist in focusing review resources. NYPORTS categories were matched to corresponding combinations of inpatient ICD-9-CM diagnosis and procedure codes. Other variables considered included discharge disposition, primary or secondary coding position, readmissions, and NYPORTS exclusions. Among more than 60,000 discharges in 2 years, 5,500 records were identified for NYPORTS review based on the ICD-9-CM criteria; 211 cases had already been reported through normal reporting processes. Thirteen of the NYPORTS codes had a 30% or greater match rate to the ICD-9-CM codes, with an average "hit rate" of 56%. Five-hundred sixty reviews identified 187 (33.4%) reportable events for the same code the case was being screened for and 26 additional reportable events for a code other than the screening code. NYPORTS categories for procedure and operative-related occurrences had the highest yields. This retrospective effort helped identify previously unreported occurrences, increase institutional awareness of New York State's mandatory reporting process, and stimulate the redesign of our concurrent detection process.

Mapping and imaging deep-sea coral reefs off Norway, 1982–2000

The survey and mapping group (SMG) of Statoil is responsible for all seafloor mapping for pipelines and field development in Statoil. During numerous reconnaissance and pipeline route surveys over large portions of our contintental shelf, in the North, Norwegian and Barents Seas, we have only detected deep-water coral reefs in a few specific areas. The first reef we found was in 1982, using a combined side scan sonar and sub-bottom profiler system off Fugloy, northern-Norway. Thereafter, numerous reefs were mapped with similar systems off mid-Norway, during the period 1985–1990 for the reconnaissance and final route mapping of the Haltenpipe project. During 1997, we also mapped some previously known reefs in the Trondheimsfjord area while surveying a route for the Tjeldbergodden - Skogn pipeline project. Between 1997 and 2000, we have mapped more reefs along pipeline routes on the outer mid-Norway continental shelf. These reefs are of a smaller size (less than 5 m high) than those mentioned above (5–31 m high). Although side scan sonar and sub-bottom profilers provide a less ambiguous detection of reefs, we have found that modern multi-beam echosounder data can provide adequate remotely sensed data for deep-water coral reef mapping. The interpretation of the reefs is based on visual documentation by ROV (remotely operated vehicle) or by sampling with gravity corers and grabs (ground-truthing). Based on a limited amount of such ground-truthing, it has been possible to extrapolate and use the specific morphological characteristics of the reefs to map their density and distribution. For the Haltenpipe project, we mapped an offshore route corridor of about 200 km length at a width of 3 km with multi-beam echosounder. On the basis of ground-truthing 14 of the suspected coral reefs, we have found the total number of reefs to be 57 within the 600 km2 mapped area. All these reefs are higher than 5 m (the highest is 31 m) and of diameters at their base of more than 50 m. Although they occur in local clusters with up to 10 reefs per km2, the mean density of reefs along the entire (200 km long) transect is only 0.09 suspected reefs per km2. However, there is a large regional density variation, with the highest regional density being 1.2 reefs per km2 in an area of subcropping Palaeocene sedimentary rocks. A brief discussion of why the corals have constructed their reefs in the deep, cool, and generally `hostile' waters of the Norwegian continental shelf and fjords concludes with them probably subsisting on a reliable and steady nutrient source, independent of season and variations in the Atlantic Drift (`Gulf stream'). This positive environmental component is called `hydraulically active substrata'. It is thus speculated that micro-organisms, bacteria etc., utilizing the hydraulically activated chemical porewater gradients, cause a local enrichment on which the cnidarian organisms ultimately depend.

Risk of bladder cancer by geographic region in a U.S. cohort of male health professionals.

Large regional variations in bladder cancer rates have been observed for numerous decades in the United States and persist to date. We examined the incidence rates of bladder cancer by geographic region among U.S. male health professionals to determine whether diet or other lifestyle factors can account for variations observed. During 12 years of follow-up, 328 cases of bladder cancer were diagnosed in the Health Professionals Follow-up Study cohort. We inquired about diet, lifetime history of smoking, race, marital status, and other nondietary factors using mailed questionnaires. An elevated risk of bladder cancer was observed in the Northeast compared with the West [relative risk (RR) = 1.71, 95% confidence interval (CI) = 1.23-2.39], which was slightly attenuated after controlling for smoking (RR = 1.65, 95% CI = 1.18-2.30). Smoking patterns, diet, and other lifestyle factors could not account for all of the elevated bladder cancer risk in the Northeast. Bladder cancer risk was highest among men who had a long residency in the Northeast compared with a long residency in the West (RR = 1.77, 95% CI = 1.15-2.71, adjusted for smoking). Diet and other known characteristics do not appear to be responsible for the regional variations in bladder cancer rates in the United States.

Analysis of the hydrology and flow of nitrogen in 17 Danish catchments

In the search for tools for evaluating the effects of national action plans combating diffuse nutrient pollution causing eutrophication of surface waters, a study of the nitrogen (N) flow in 17 Danish agricultural catchments was carried out. Data on N input and N harvest for the agricultural year of 1993/1994 was obtained from questionnaire surveys facilitating the set up of N balances. Net export of N from the catchments measured at the outlet was obtained from time-series of stream water chemistry and discharge from 1993-1997. N leaching from the root zone of each field was calculated using an empirical model. A physically based lumped rainfall-runoff model was used for separating the hydrograph time-series into three runoff components: baseflow, interflow and overland flow. Large regional variations in net N input were found ranging from 62 kg N ha(-1) yr(-1) in the loamy eastern part of the country dominated by cereal production to 137 kg N ha(-1) yr(-1) in the western part characterised by less fertile sandy soils and dominated by animal husbandry. N leaching from the root zone showed a corresponding variation with regional averages ranging from 34.5 kg N ha(-1) yr(-1) to 90.9 kg N ha(-1) yr(-1). No similar regional pattern could however be found regarding net N export, and no relationship could be established between net N export and root zone N leaching. This finding was ascribed to a varying and in some catchments very high (>80%) N retention during subsurface transport to the stream. The hydrological modelling revealed that loamy catchments had a high proportion of quick flow (overland flow + interflow), whereas baseflow dominated the sandy catchments. Further, a highly significant relationship between N retention and proportion of quick flow was found emphasising the importance of understanding the hydrological pathways. This should be taken into consideration when evaluating the N loading of surface waters resulting from a given agricultural practice and the effects of possible changes in this practice.

A descriptive study of UK cancer genetics services: an emerging clinical response to the new genetics.

The objective was to describe NHS cancer genetic counselling services and compare UK regions. The study design was a cross-sectional study over 4 weeks and attendee survey. The setting was 22 of the 24 regional cancer genetics services in the UK NHS. Participants were individuals aged over 18 attending clinics at these services. Outcome measures were staff levels, referral rates, consultation rates, follow-up plans, waiting time. There were only 11 dedicated cancer geneticists across the 22 centres. Referrals were mainly concerned with breast (63%), bowel (18%) and ovarian (12%) cancers. Only 7% of referrals were for men and 3% were for individuals from ethnic minorities. Referral rates varied from 76 to 410 per million per annum across the regions. Median waiting time for an initial appointment was 19 weeks, ranging across regions from 4 to 53 weeks. Individuals at population-level genetic risk accounted for 27% of consultations (range 0%, 58%). Shortfalls in cancer genetics staff and in the provision of genetic testing and cancer surveillance have resulted in large regional variations in access to care. Initiatives to disseminate referral and management guidelines to cancer units and primary care should be adequately resourced so that clinical genetics teams can focus on the genetic testing and management of high-risk families. © 2001 Cancer Research Campaign http://www.bjcancer.com

Evaluation of prenatal diagnosis of associated congenital heart diseases by fetal ultrasonographic examination in Europe.

Ultrasound scans in the mid trimester of pregnancy are now a routine part of antenatal care in most European countries. With the assistance of Registries of Congenital Anomalies a study was undertaken in Europe. The objective of the study was to evaluate prenatal detection of congenital heart defects (CHD) by routine ultrasonographic examination of the fetus. All congenital malformations suspected prenatally and all congenital malformations, including chromosome anomalies, confirmed at birth were identified from the Congenital Malformation Registers, including 20 registers from the following European countries: Austria, Croatia, Denmark, France, Germany, Italy, Lithuania, Spain, Switzerland, The Netherlands, UK and Ukrainia. These registries follow the same methodology. The study period was 1996-1998, 709 030 births were covered, and 8126 cases with congenital malformations were registered. If more than one cardiac malformation was present the case was coded as complex cardiac malformation. CHD were subdivided into 'isolated' when only a cardiac malformation was present and 'associated' when at least one other major extra cardiac malformation was present. The associated CHD were subdivided into chromosomal, syndromic non-chromosomal and multiple. The study comprised 761 associated CHD including 282 cases with multiple malformations, 375 cases with chromosomal anomalies and 104 cases with non-chromosomal syndromes. The proportion of prenatal diagnosis of associated CHD varied in relation to the ultrasound screening policies from 17.9% in countries without routine screening (The Netherlands and Denmark) to 46.0% in countries with only one routine fetal scan and 55.6% in countries with two or three routine fetal scans. The prenatal detection rate of chromosomal anomalies was 40.3% (151/375 cases). This rate for recognized syndromes and multiply malformed with CHD was 51.9% (54/104 cases) and 48.6% (137/282 cases), respectively; 150/229 Down syndrome (65.8%) were livebirths. Concerning the syndromic cases, the detection rate of deletion 22q11, situs anomalies and VATER association was 44.4%, 64.7% and 46.6%, respectively. In conclusion, the present study shows large regional variations in the prenatal detection rate of CHD with the highest rates in European regions with three screening scans. Prenatal diagnosis of CHD is significantly higher if associated malformations are present. Cardiac defects affecting the size of the ventricles have the highest detection rate. Mean gestational age at discovery was 20-24 weeks for the majority of associated cardiac defects.

Reducing global inequalities in child health

Since 1950, global poverty and child mortality rates have declined more rapidly than during any other period in history. Progress has been uneven, however, so that inequalities have widened; since...

Maternal caffeine intake has minor effects on adenosine receptor ontogeny in the rat brain.

Maternal caffeine intake has been suggested to influence the offspring. We have studied the effects of maternal caffeine intake on adenosine and GABA receptors, targets for caffeine, during development of the rat brain. Caffeine (0.3 g/L) was added to the drinking water of rat dams during pregnancy and early postnatal life. Adenosine A1 and A2A and GABAA receptor development was studied using receptor autoradiography and in situ hybridization. Pups were examined on embryonic d 14 (E14), E18, E21, 2 h after birth (P2h), P24h, postnatal d 3 (P3), P7, P14, and P21. Adenosine A, receptor mRNA was detected at E14 and receptors at E18. A1 mRNA levels increased from the level reached at E18 between P3 and P14 (maximally a doubling), whereas A, receptors, studied by [3H]-1,3-dipropyl-8-cyclopentyl xanthine binding, increased later and to a much larger extent (about 10-fold) postnatally. Caffeine treatment had no significant effect on adenosine A1 receptors or on A1 receptor mRNA. A2A mRNA had reached adult levels by E18, whereas receptor levels were low or undetectable before birth and increased dramatically until P14. Caffeine did not influence A2A receptors or A2A receptor mRNA at any stage during development. [3H]-flunitrazepam binding, representing GABAA receptors, showed large regional variations during ontogeny, but there were no clear differences between the caffeine-exposed and the nonexposed pups. Thus, exposure to a low dose of caffeine during gestation and postnatal life had only minor effects on development of adenosine A, and A2A receptors and GABAA receptors in the rat brain.

A future for neonatal α1‐antitrypsin screening?*

A WHO expert group recommends neonatal screening for α1‐antitrypsin deficiency (α1ATD). Homozygous α1ATD PiZZ occurs in 1 in 5000 of the U.S. Caucasian population and up to 1 in 500 individuals of the European population, with a large regional variation. It is a risk factor that predisposes mainly to liver disease in early infancy and emphysema in early adulthood. Most importantly, smoking decreases the duration of the asymptomatic phase and life expectancy by 10‐20 y. The Swedish α1AT screening programme and subsequent information and advice prevented the majority of adolescents from starting to smoke. The involved parents and α1ATD adolescents retrospectively recommended neonatal screening. Potential advantages of neonatal α1AT screening are: early diagnosis and treatment of neonatal liver disease, optimal treatment of fever and bacterial infections theoretically preventing liver cell damage, genetic advice and information about the consequences of passive and active smoking. Potential advantages of postponing screening until age 11‐12 y are: identification of α1ATD close to the age when smoking may start, and possibility for the child to take part in the screening decision. Disadvantages of α1AT screening are: psychosocial reactions–the mother probably being most vulnerable in the neonatal period–and discrimination by insurance companies and employers.Important uncertainties are: lack of knowledge concerning participation in a voluntary α1AT screening, psychosocial reactions and the efficacy of anti‐smoking advice if the information is given to school‐age children and families. Thus the question whether and when to screen for α1ATD is still the topic of lively debate.

Heroin-related deaths in regional New South Wales, 1992-96

The coronial files of all 188 heroin-related fatalities that occurred in regional New South Wales between 1992 and 1996 were inspected. There was a significant increase in fatalities, rising from 23 deaths in 1992 to 53 during 1996. The regions in which the most deaths occurred were Wollongong/ Illawarra (43 deaths), Newcastle/Hunter (35) and the far north coast (25). The mean age of cases was 31.5 years and 83% were male, and there were no significant trends in demographic characteristics of cases over the study period. The median blood morphine concentration of cases was 0.39mg/l (range 0.05-4.5mg/l). Alcohol was detected in 50% of cases and benzodiazepines in 29%. There were large regional variations in toxicology results, with median blood morphine concentrations ranging from 0.25mg/l among south coast cases to 0.56mg/l in mid-western New South Wales. Compared to Sydney metropolitan cases, regional cases had a higher median blood morphine concentration, were less likely to have cocaine detected, were ...

A future for neonatal α1-antitrypsin screening?

A WHO expert group recommends neonatal screening for α1-antitrypsin deficiency (α1ATD). Homozygous α1ATD PiZZ occurs in 1 in 5000 of the U.S. Caucasian population and up to 1 in 500 individuals of the European population, with a large regional variation. It is a risk factor that predisposes mainly to liver disease in early infancy and emphysema in early adulthood. Most importantly, smoking decreases the duration of the asymptomatic phase and life expectancy by 10-20 y. The Swedish α1AT screening programme and subsequent information and advice prevented the majority of adolescents from starting to smoke. The involved parents and α1ATD adolescents retrospectively recommended neonatal screening. Potential advantages of neonatal α1AT screening are: early diagnosis and treatment of neonatal liver disease, optimal treatment of fever and bacterial infections theoretically preventing liver cell damage, genetic advice and information about the consequences of passive and active smoking. Potential advantages of postponing screening until age 11-12 y are: identification of α1ATD close to the age when smoking may start, and possibility for the child to take part in the screening decision. Disadvantages of α1AT screening are: psychosocial reactions–the mother probably being most vulnerable in the neonatal period–and discrimination by insurance companies and employers. Important uncertainties are: lack of knowledge concerning participation in a voluntary α1AT screening, psychosocial reactions and the efficacy of anti-smoking advice if the information is given to school-age children and families. Thus the question whether and when to screen for α1ATD is still the topic of lively debate.

A future for neonatal a1-antitrypsin screening?

A WHO expert group recommends neonatal screening for alpha1-antitrypsin deficiency (alpha1ATD). Homozygous alpha1ATD PiZZ occurs in 1 in 5,000 of the U.S. Caucasian population and up to 1 in 500 individuals of the European population, with a large regional variation. It is a risk factor that predisposes mainly to liver disease in early infancy and emphysema in early adulthood. Most importantly, smoking decreases the duration of the asymptomatic phase and life expectancy by 10-20 y. The Swedish alpha1AT screening programme and subsequent information and advice prevented the majority of adolescents from starting to smoke. The involved parents and alpha1ATD adolescents retrospectively recommended neonatal screening. Potential advantages of neonatal alpha1AT screening are: early diagnosis and treatment of neonatal liver disease, optimal treatment of fever and bacterial infections theoretically preventing liver cell damage, genetic advice and information about the consequences of passive and active smoking. Potential advantages of postponing screening until age 11-12 y are: identification of alpha1ATD close to the age when smoking may start, and possibility for the child to take part in the screening decision. Disadvantages of alpha1AT screening are: psychosocial reactions-the mother probably being most vulnerable in the neonatal period-and discrimination by insurance companies and employers. Important uncertainties are: lack of knowledge concerning participation in a voluntary alpha1AT screening, psychosocial reactions and the efficacy of anti-smoking advice if the information is given to school-age children and families. Thus the question whether and when to screen for alpha1ATD is still the topic of lively debate.

Combining satellite data and biogeochemical models to estimate global effects of human‐induced land cover change on carbon emissions and primary productivity

This study uses a global terrestrial carbon cycle model (the Carnegie‐Ames‐Stanford Approach (CASA) model), a satellite‐derived map of existing vegetation, and global maps of natural vegetation to estimate the effects of human‐induced land cover change on carbon emissions to the atmosphere and net primary production. We derived two maps approximating global land cover that would exist for current climate in the absence of human disturbance of the landscape, using a procedure that minimizes disagreements between maps of existing and natural vegetation that represent artifacts in the data. Similarly, we simulated monthly fields of the Normalized Difference Vegetation Index, required as input to CASA, for the undisturbed land cover case. Model results estimate total carbon losses from human‐induced land cover changes of 182 and 199 Pg for the two simulations, compared with an estimate of 124 Pg for total flux between 1850 and 1990 [Houghton, 1999], suggesting that land cover change prior to 1850 accounted for approximately one‐third of total carbon emissions from land use change. Estimates of global carbon loss from the two independent methods, the modeling approach used in this paper and the accounting approach of Houghton [1999], are comparable taking into account carbon losses from agricultural expansion prior to 1850 estimated at 48–57 Pg. However, estimates of regional carbon losses vary considerably, notably in temperate midlatitudes where our estimates indicate higher cumulative carbon loss. Overall, land cover changes reduced global annual net primary productivity (NPP) by approximately 5%, with large regional variations. High‐input agriculture in North America and Europe display higher annual NPP than the natural vegetation that would exist in the absence of cropland. However, NPP has been depleted in localized areas in South Asia and Africa by up to 90%. These results provide initial crude estimates, limited by the spatial resolution of the data sets used as input to the model and by the lack of information about transient changes in land cover. The results suggest that a modeling approach can be used to estimate spatially‐explicit effects of land cover change on biosphere‐atmosphere interactions.