Environmental factor

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An environmental factor, ecological factor or eco factor is any factor, abiotic or biotic, that influences living organisms. [1] Abiotic factors include ambient temperature, amount of sunlight, air, soil, water and pH of the water soil in which an organism lives. Biotic factors would include the availability of food organisms and the presence of biological specificity, competitors, predators, and parasites.

Contents

Overall

Cancer is mainly the result of environmental factors DARK CLOUDS OF FACTORY SMOKE OBSCURE CLARK AVENUE BRIDGE - NARA - 550179.jpg
Cancer is mainly the result of environmental factors

An organism's genotype (e.g., in the zygote) translated into the adult phenotype through development during an organism's ontogeny, and subject to influences by many environmental effects. In this context, a phenotype (or phenotypic trait) can be viewed as any definable and measurable characteristic of an organism, such as its body mass or skin color.[ citation needed ]

Apart from the true monogenic genetic disorders, environmental factors may determine the development of disease in those genetically predisposed to a particular condition. Pollution, stress, physical and mental abuse, diet, exposure to toxins, pathogens, radiation and chemicals found in almost all[ quantify ] personal-care products and household cleaners are common environmental factors that determine a large segment of non-hereditary disease.[ citation needed ]

If a disease process is concluded to be the result of a combination of genetic and environmental factor influences, its etiological origin can be referred to as having a multifactorial pattern.[ citation needed ]

Cancer is often related to environmental factors. [2] Maintaining a healthy weight, eating a healthy diet, minimizing alcohol and eliminating smoking reduces the risk of developing the disease, according to researchers. [2]

Environmental triggers for asthma [3] and autism [4] have been studied too.

Exposome

The exposome encompasses the set of human environmental (i.e. non-genetic) exposures from conception onwards, complementing the genome. The exposome was first proposed in 2005 by cancer epidemiologist Christopher Paul Wild in an article entitled "Complementing the genome with an "exposome": the outstanding challenge of environmental exposure measurement in molecular epidemiology". [5] The concept of the exposome and how to assess it has led to lively discussions with varied views in 2010, [6] [7] 2012, [8] [9] [10] [11] [12] [13] 2014 [14] [15] and 2021. [16]

In his 2005 article, Wild stated, "At its most complete, the exposome encompasses life-course environmental exposures (including lifestyle factors), from the prenatal period onwards." The concept was first proposed to draw attention to the need for better and more complete environmental exposure data for causal research, in order to balance the investment in genetics. According to Wild, even incomplete versions of the exposome could be useful to epidemiology. In 2012, Wild outlined methods, including personal sensors, biomarkers, and 'omics' technologies, to better define the exposome. [8] [17] He described three overlapping domains within the exposome:

  1. a general external environment including the urban environment, education, climate factors, social capital, stress,
  2. a specific external environment with specific contaminants, radiation, infections, lifestyle factors (e.g. tobacco, alcohol), diet, physical activity, etc.
  3. an internal environment to include internal biological factors such as metabolic factors, hormones, gut microflora, inflammation, oxidative stress.
Exposome Exposome nruaux.jpg
Exposome

In late 2013, this definition was explained in greater depth in the first book on the exposome. [18] [19] In 2014, the same author revised the definition to include the body's response with its endogenous metabolic processes which alter the processing of chemicals. [14] More recently, evidenced by metabolic exposures in and around the time of pregnancy, the maternal metabolic exposome [20] includes exposures such as maternal obesity/overweight and diabetes, and malnutrition, including high fat/high calorie diets, which are associated with poor fetal, infant and child growth, [21] and increased incidence of obesity and other metabolic disorders in later life.

Measurement

For complex disorders, specific genetic causes appear to account for only 10-30% of the disease incidence, but there has been no standard or systematic way to measure the influence of environmental exposures. Some studies into the interaction of genetic and environmental factors in the incidence of diabetes have demonstrated that "environment-wide association studies" (EWAS, or exposome-wide association studies) may be feasible. [22] [23] However, it is not clear what data sets are most appropriate to represent the value of "E". [24]

Research initiatives

As of 2016, it may not be possible to measure or model the full exposome, but several European projects have started to make first attempts. In 2012, the European Commission awarded two large grants to pursue exposome-related research. [25] The HELIX project at the Barcelona-based Centre for Research in Environmental Epidemiology was launched around 2014, and aimed to develop an early-life exposome. [13] A second project, Exposomics, based at Imperial College London, launched in 2012, aimed to use smartphones utilising GPS and environmental sensors to assess exposures. [25] [26]

In late 2013, a major initiative called the "Health and Environment-Wide Associations based on Large Scale population Surveys" or HEALS, began. Touted as the largest environmental health-related study in Europe, HEALS proposes to adopt a paradigm defined by interactions between DNA sequence, epigenetic DNA modifications, gene expression, and environmental factors. [27]

In December 2011, the US National Academy of Sciences hosted a meeting entitled "Emerging Technologies for Measuring Individual Exposomes." [28] A Centers for Disease Control and Prevention overview, "Exposome and Exposomics", outlines the three priority areas for researching the occupational exposome as identified by the National Institute for Occupational Safety and Health. [11] The National Institutes of Health (NIH) has invested in technologies supporting exposome-related research including biosensors, and supports research on gene–environment interactions. [29] [30]

Proposed Human Exposome Project (HEP)

The idea of a Human Exposome Project, analogous to the Human Genome Project, has been proposed and discussed in numerous scientific meetings, but as of 2017, no such project exists. Given the lack of clarity on how science would go about pursuing such a project, support has been lacking. [31] Reports on the issue include:

The concept of the exposome has contributed to the 2010 proposal of a new paradigm in disease phenotype, "the unique disease principle": Every individual has a unique disease process different from any other individual, considering uniqueness of the exposome and its unique influence on molecular pathologic processes including alterations in the interactome. [35] This principle was first described in neoplastic diseases as "the unique tumor principle". [36] Based on this unique disease principle, the interdisciplinary field of molecular pathological epidemiology (MPE) integrates molecular pathology and epidemiology. [37]

Socioeconomic drivers

Global change is driven by many factors; however the five main drivers of global change are: population growth, economic growth, technological advances, attitudes, and institutions. [38] These five main drivers of global change can stem from socioeconomic factors which in turn, these can be seen as drivers in their own regard.  Socioeconomic drivers of climate change can be triggered by a social or economic demand for resources such as a demand for timber or a demand for agricultural crops.  In tropical deforestation for instance, the main driver is economic opportunities that come the extraction of these resources and the conversion of this land to crop or rangelands. [39] These drivers can be manifested at any level, from the global level demand for timber all the way to the household level.[ citation needed ]

An example of how socioeconomic drivers affect climate change can be seen in the soy bean trading between Brazil and China. The trading of soy beans from to Brazil and China has grown immensely in the past few decades. This growth in trade between these two countries is stimulated by socioeconomic drivers. Some of the socioeconomic drivers in play here are the rising demand for Brazilian soy beans in China, the increase in land use change for soy bean production in Brazil, and the importance of strengthening foreign trade between the two countries. [40] All of these socioeconomic drivers have implications in climate change. For instance, an increase in the development for soy bean croplands in Brazil means there needs to be more and more land made available for this resource. This causes the general land cover of forest to be converted into croplands which in its own regard has an impact on the environment. [41] This example of land use change driven by a demand of a resource, isn't only happening in Brazil with soy bean production.[ citation needed ]

Harvesting crawfish in Acadia Parish, Louisiana. Crawfish Farming - Acadia Parish Louisiana 2020.jpg
Harvesting crawfish in Acadia Parish, Louisiana.

Another example came from The Renewable Energy Directive 2009 Union when they mandated biofuel development for countries within their membership. With an international socioeconomic driver of increasing the production biofuels comes affects in land use in these countries. When agricultural cropland shift to bioenergy cropland the original crop supply decreases while the global market for this crop increases. This causes a cascading socioeconomic driver for the need for more agricultural croplands to support the growing demand. However, with the lack of available land from the crop substitution to biofuels, countries must look into areas further away to develop these original croplands. This causes spillover systems in countries where this new development takes place. For instance, African countries are converting savanna's into cropland and this all stems from the socioeconomic driver of wanting to develop biofuels. [42] Furthermore, socioeconomic driver that cause land use change don't all occur at an international level. These drivers can be experienced all the way down to the household level. Crop substitution doesn't only come from biofuel shifts in agriculture, a big substitution came from Thailand when they switched the production of opium poppy plants to non-narcotic crops. This caused Thailand's agricultural sector to grow, but it caused global rippling effects (opium replacement).[ citation needed ]

For instance, in Wolong China, locals use forests as fuelwood to cook and heat their homes. So, the socioeconomic driver in play here is the local demand for timber to support subsistence in this area. With this driver, locals are depleting their supply for fuelwood so they have to keep moving further away to extract this resource. This movement and demand for timber is in turn contributing to the loss of pandas in this area because their ecosystem is getting destroyed. [43]

However, when researching local trends the focus tends to be on outcomes instead of on how changes in the global drivers affect outcomes. [44] With this being said, community level planning needs to be implemented when analyzing socioeconomic drivers of change.[ citation needed ]

In conclusion, one can see how socioeconomic drivers at any level play a role in the consequences of human actions on the environment. These drivers all have cascading effects on land, humans, resources, and the environment as a whole. With this being said, humans need to fully understand how their socioeconomic drivers can change the way we live. For instance, going back to the soy bean example, when the supply can't meet the demand for soy beans the global market for this crop increases which then in turn affects countries that rely on this crop for a food source. These affects can cause a higher price for soy beans at their stores and markets or it can cause an overall lack of availability for this crop in importing countries. With both of these outcomes, the household level is being affected by a national level socioeconomic driver of an increased demand for Brazilian soy beans in China. From just this one example alone, one can see how socioeconomic drivers influence changes at a national level that then lead to more global, regional, communal, and household level changes. The main concept to take away from this is the idea that everything is connected and that our roles and choices as humans have major driving forces that impact our world in numerous ways.[ citation needed ]

See also

Related Research Articles

<span class="mw-page-title-main">Epidemic</span> Rapid spread of disease affecting a large number of people in a short time

An epidemic is the rapid spread of disease to a large number of hosts in a given population within a short period of time. For example, in meningococcal infections, an attack rate in excess of 15 cases per 100,000 people for two consecutive weeks is considered an epidemic.

<span class="mw-page-title-main">Epidemiology</span> Study of health and disease within a population

Epidemiology is the study and analysis of the distribution, patterns and determinants of health and disease conditions in a defined population.

The science of epidemiology has matured significantly from the times of Hippocrates, Semmelweis and John Snow. The techniques for gathering and analyzing epidemiological data vary depending on the type of disease being monitored but each study will have overarching similarities.

<span class="mw-page-title-main">Environmental health</span> Public health branch focused on environmental impacts on human health

Environmental health is the branch of public health concerned with all aspects of the natural and built environment affecting human health. To effectively control factors that may affect health, the requirements that must be met to create a healthy environment must be determined. The major sub-disciplines of environmental health are environmental science, toxicology, environmental epidemiology, and environmental and occupational medicine.

<span class="mw-page-title-main">Gene–environment interaction</span> Response to the same environmental variation differently by different genotypes

Gene–environment interaction is when two different genotypes respond to environmental variation in different ways. A norm of reaction is a graph that shows the relationship between genes and environmental factors when phenotypic differences are continuous. They can help illustrate GxE interactions. When the norm of reaction is not parallel, as shown in the figure below, there is a gene by environment interaction. This indicates that each genotype responds to environmental variation in a different way. Environmental variation can be physical, chemical, biological, behavior patterns or life events.

Spatial epidemiology is a subfield of epidemiology focused on the study of the spatial distribution of health outcomes; it is closely related to health geography.

Exposure science is the study of the contact between humans and harmful agents within their environment – whether it be chemical, physical, biological, behavioural or mental stressors – with the aim of identifying the causes and preventions of the adverse health effects they result in. This can include exposure within the home, workplace, outdoors or any other environment an individual may encounter. The term 'exposure' is the umbrella term for many different types, ranging from ultraviolet exposure, exposure to the chemicals in the food we eat, to exposure to long working hours being the occupational factor most attributable to the burden of disease.

<span class="mw-page-title-main">Air pollution</span> Presence of dangerous substances in the atmosphere

Air pollution is the contamination of air due to the presence of substances called pollutants in the atmosphere that are harmful to the health of humans and other living beings, or cause damage to the climate or to materials. It is also the contamination of the indoor or outdoor environment either by chemical, physical, or biological agents that alters the natural features of the atmosphere. There are many different types of air pollutants, such as gases, particulates and biological molecules. Air pollution can cause diseases, allergies, and even death to humans; it can also cause harm to other living organisms such as animals and crops, and may damage the natural environment or built environment. Air pollution can be caused by both human activities and natural phenomena.

Environmental epidemiology is a branch of epidemiology concerned with determining how environmental exposures impact human health. This field seeks to understand how various external risk factors may predispose to or protect against disease, illness, injury, developmental abnormalities, or death. These factors may be naturally occurring or may be introduced into environments where people live, work, and play.

Molecular epidemiology is a branch of epidemiology and medical science that focuses on the contribution of potential genetic and environmental risk factors, identified at the molecular level, to the etiology, distribution and prevention of disease within families and across populations. This field has emerged from the integration of molecular biology into traditional epidemiological research. Molecular epidemiology improves our understanding of the pathogenesis of disease by identifying specific pathways, molecules and genes that influence the risk of developing disease. More broadly, it seeks to establish understanding of how the interactions between genetic traits and environmental exposures result in disease.

While epidemiology is "the study of the distribution and determinants of states of health in populations", social epidemiology is "that branch of epidemiology concerned with the way that social structures, institutions, and relationships influence health." This research includes "both specific features of, and pathways by which, societal conditions affect health".

In epidemiology, environmental diseases are diseases that can be directly attributed to environmental factors. Apart from the true monogenic genetic disorders, which are rare, environment is a major determinant of the development of disease. Diet, exposure to toxins, pathogens, radiation, and chemicals found in almost all personal care products and household cleaners, stress, racism, and physical and mental abuse are causes of a large segment of non-hereditary disease. If a disease process is concluded to be the result of a combination of genetic and environmental factor influences, its etiological origin can be referred to as having a multifactorial pattern.

<span class="mw-page-title-main">Effects of climate change on human health</span>

The effects of climate change on human health are profound because they increase heat-related illnesses and deaths, respiratory diseases, and the spread of infectious diseases. There is widespread agreement among researchers, health professionals and organizations that climate change is the biggest global health threat of the 21st century.

<span class="mw-page-title-main">Exposome</span> Concept on environmental exposures

The exposome is a concept used to describe environmental exposures that an individual encounters throughout life, and how these exposures impact biology and health. It encompasses both external and internal factors, including chemical, physical, biological, and social factors that may influence human health.

"Envirome" is a concept that relates the core of environmental conditions with the successful biological performance of living beings. This concept was created in genetic epidemiology, in which an envirome is defined as the total set of environmental factors, both present, and past, that affect the state, and in particular the disease state, of an organism. The study of the envirome and its effects is termed enviromics. The term was first coined in the field of psychiatric epidemiology by J.C. Anthony in 1995. More recently, use of the term has been extended to the cellular domain, where cell functional enviromics studies both the genome and envirome from a systems biology perspective. In plants, enviromics is directly related to complex ecophysiology, in which the wide environment of the plants, into an omics scale, can be dissected and understood as a mosaic of possible growing factors and the balance of diverse resources available. In ecology, this concept can be related to the Shelford's law of tolerance. The enviromics is conceived as a pillar of the Modern Plant Breeding, capable to connect the design and development of breeding goals concealing it with the agronomic targets for a climate-smart agriculture. It also has the ability to bridge the knowledge gaps between the different levels of systems biology and phenomics in the context of Gene–environment interaction.

Molecular pathological epidemiology is a discipline combining epidemiology and pathology. It is defined as "epidemiology of molecular pathology and heterogeneity of disease". Pathology and epidemiology share the same goal of elucidating etiology of disease, and MPE aims to achieve this goal at molecular, individual and population levels. Typically, MPE utilizes tissue pathology resources and data within existing epidemiology studies. Molecular epidemiology broadly encompasses MPE and conventional-type molecular epidemiology with the use of traditional disease designation systems.

Paolo Vineis is an Italian professor of Environmental Epidemiology at Imperial College London.

Agricultural expansion describes the growth of agricultural land especially in the 20th and 21st centuries.

Frederica Perera is an American environmental health scientist and the founder of the Columbia Center for Children's Environmental Health at the Columbia University Mailman School of Public Health. Her research career has focused on identifying and preventing harm to children from prenatal and early childhood exposure to environmental chemicals and pollutants. She is internationally recognized for pioneering the field of molecular epidemiology, incorporating molecular techniques into epidemiological studies to measure biologic doses, preclinical responses and susceptibility to toxic exposure.

<span class="mw-page-title-main">Roel Vermeulen</span> Dutch epidemiologist

Roel Vermeulen is a Dutch scientist and professor of Environmental epidemiology and Exposome Science at the Institute for Risk Assessment Sciences at Utrecht University and the Julius Centre for Health Sciences and Primary Care at the University Medical Center Utrecht, the Netherlands. In 2024 Prof. Vermeulen was appointed as Distinguished University Professor of Utrecht University in which role he will focus on the theme of planetary and preventive health.

References

  1. Gilpin A (1996). Dictionary of Environment and Sustainable Development. John Wiley and Sons. p. 247.
  2. 1 2 3 Gallagher J (17 December 2015). "Cancer is not just 'bad luck' but down to environment, study suggests". BBC. Retrieved 17 December 2015.
  3. "Asthma and Its Environmental Triggers" (PDF). National Institute of Environmental Health Sciences . May 2006. Retrieved 5 March 2010.
  4. "Study showing evidence of a major environmental trigger for autism". PhysOrg . November 10, 2008. Retrieved 5 March 2010.
  5. Wild CP (August 2005). "Complementing the genome with an "exposome": the outstanding challenge of environmental exposure measurement in molecular epidemiology". Cancer Epidemiology, Biomarkers & Prevention. 14 (8): 1847–1850. doi: 10.1158/1055-9965.EPI-05-0456 . PMID   16103423.
  6. Rappaport SM, Smith MT (October 2010). "Epidemiology. Environment and disease risks". Science. 330 (6003): 460–461. doi:10.1126/science.1192603. PMC   4841276 . PMID   20966241.
  7. Rappaport SM (2011). "Implications of the exposome for exposure science". Journal of Exposure Science & Environmental Epidemiology. 21 (1): 5–9. doi: 10.1038/jes.2010.50 . PMID   21081972.
  8. 1 2 Wild CP (February 2012). "The exposome: from concept to utility". International Journal of Epidemiology. 41 (1): 24–32. doi: 10.1093/ije/dyr236 . PMID   22296988.
  9. Peters A, Hoek G, Katsouyanni K (February 2012). "Understanding the link between environmental exposures and health: does the exposome promise too much?". Journal of Epidemiology and Community Health. 66 (2): 103–105. doi: 10.1136/jech-2011-200643 . PMID   22080817.
  10. Buck Louis GM, Sundaram R (September 2012). "Exposome: time for transformative research". Statistics in Medicine. 31 (22): 2569–2575. doi:10.1002/sim.5496. PMC   3842164 . PMID   22969025.
  11. 1 2 "Exposome and Exposomics". Centers for Disease Control and Prevention . 2012. Retrieved 5 March 2013.
  12. Buck Louis GM, Yeung E, Sundaram R, Laughon SK, Zhang C (May 2013). "The exposome--exciting opportunities for discoveries in reproductive and perinatal epidemiology". Paediatric and Perinatal Epidemiology. 27 (3): 229–236. doi:10.1111/ppe.12040. PMC   3625972 . PMID   23574410.
  13. 1 2 Vrijheid M, Slama R, Robinson O, Chatzi L, Coen M, van den Hazel P, et al. (June 2014). "The human early-life exposome (HELIX): project rationale and design". Environmental Health Perspectives. 122 (6): 535–544. doi:10.1289/ehp.1307204. PMC   4048258 . PMID   24610234.
  14. 1 2 Miller GW, Jones DP (January 2014). "The nature of nurture: refining the definition of the exposome". Toxicological Sciences. 137 (1): 1–2. doi:10.1093/toxsci/kft251. PMC   3871934 . PMID   24213143.
  15. Greenland S, Hernán M, dos Santos Silva I, Last JM (2014). Porta M (ed.). A dictionary of epidemiology (6th ed.). New York: Oxford University Press. ISBN   9780199976737.
  16. Zhang X, Gao P, Snyder MP (July 2021). "The Exposome in the Era of the Quantified Self". Annual Review of Biomedical Data Science. 4 (1): 255–277. doi:10.1146/annurev-biodatasci-012721-122807. PMID   34465170. S2CID   237374961.
  17. Warth B, Spangler S, Fang M, Johnson CH, Forsberg EM, Granados A, et al. (November 2017). "Exposome-Scale Investigations Guided by Global Metabolomics, Pathway Analysis, and Cognitive Computing". Analytical Chemistry. 89 (21): 11505–11513. doi:10.1021/acs.analchem.7b02759. PMID   28945073.
  18. Miller G (2 December 2013). The Exposome: A Primer. Elsevier. p. 118. ISBN   978-0124172173 . Retrieved 16 January 2014.
  19. Miller G (20 November 2013). "G x E = ?". Sci Connect. Elsevier. Retrieved 16 January 2014.
  20. Strain J, Spaans F, Serhan M, Davidge ST, Connor KL (October 2022). "Programming of weight and obesity across the lifecourse by the maternal metabolic exposome: A systematic review". Molecular Aspects of Medicine. 87: 100986. doi:10.1016/j.mam.2021.100986. PMID   34167845. S2CID   235635449.
  21. Wang J, Pan L, Liu E, Liu H, Liu J, Wang S, Guo J, Li N, Zhang C, Hu G (April 2019). "Gestational diabetes and offspring's growth from birth to 6 years old". International Journal of Obesity. 43 (4): 663–672. doi:10.1038/s41366-018-0193-z. PMC   6532057 . PMID   30181654.
  22. Patel CJ, Bhattacharya J, Butte AJ (May 2010). "An Environment-Wide Association Study (EWAS) on type 2 diabetes mellitus". PLOS ONE. 5 (5): e10746. Bibcode:2010PLoSO...510746P. doi: 10.1371/journal.pone.0010746 . PMC   2873978 . PMID   20505766.
  23. Patel CJ, Chen R, Kodama K, Ioannidis JP, Butte AJ (May 2013). "Systematic identification of interaction effects between genome- and environment-wide associations in type 2 diabetes mellitus". Human Genetics. 132 (5): 495–508. doi:10.1007/s00439-012-1258-z. PMC   3625410 . PMID   23334806.[ dead link ]
  24. Smith MT, Rappaport SM (August 2009). "Building exposure biology centers to put the E into "G x E" interaction studies". Environmental Health Perspectives. 117 (8): A334–A335. doi:10.1289/ehp.12812. PMC   2721881 . PMID   19672377.
  25. 1 2 Callaway E (November 2012). "Daily dose of toxics to be tracked". Nature. 491 (7426): 647. Bibcode:2012Natur.491..647C. doi: 10.1038/491647a . PMID   23192121.
  26. "About Exposomics". EU.
  27. "HEALS-EU" . Retrieved 16 January 2014.
  28. "National Academy of Sciences meeting" . Retrieved 21 January 2013.
  29. "NIEHS Gene-Environment studies" . Retrieved 21 January 2013.
  30. "Genes and Environment Initiative" . Retrieved 21 January 2013.
  31. Arnaud CH (16 August 2010). "Exposing The Exposome". Chemical & Engineering News. 88 (33). American Chemical Society: 42–44. doi:10.1021/CEN081010151709 . Retrieved 5 March 2013.
  32. Lioy PJ, Rappaport SM (November 2011). "Exposure science and the exposome: an opportunity for coherence in the environmental health sciences". Environmental Health Perspectives. 119 (11): A466–A467. doi:10.1289/ehp.1104387. PMC   3226514 . PMID   22171373.
  33. "NRC report supports NIEHS vision of the exposome" . Retrieved 21 January 2013.
  34. National Research Council, Division on Earth Life Studies, Board on Environmental Studies and Toxicology, Committee on Human Environmental Exposure Science in the 21st Century (2012-09-07). Exposure Science in the 21st Century: A Vision and a Strategy. National Academies Press. ISBN   978-0-309-26468-6 . Retrieved 21 January 2013.
  35. Ogino S, Lochhead P, Chan AT, Nishihara R, Cho E, Wolpin BM, et al. (April 2013). "Molecular pathological epidemiology of epigenetics: emerging integrative science to analyze environment, host, and disease". Modern Pathology. 26 (4): 465–484. doi:10.1038/modpathol.2012.214. PMC   3637979 . PMID   23307060.
  36. Ogino S, Fuchs CS, Giovannucci E (July 2012). "How many molecular subtypes? Implications of the unique tumor principle in personalized medicine". Expert Review of Molecular Diagnostics. 12 (6): 621–628. doi:10.1586/erm.12.46. PMC   3492839 . PMID   22845482.
  37. Ogino S, Stampfer M (March 2010). "Lifestyle factors and microsatellite instability in colorectal cancer: the evolving field of molecular pathological epidemiology". Journal of the National Cancer Institute. 102 (6): 365–367. doi:10.1093/jnci/djq031. PMC   2841039 . PMID   20208016.
  38. Liverman D, Yarnal B, Turner II BL (2003). "The Human Dimensions of Global Change.". In Gaile GL, Willmott CJ (eds.). Geography in America at the Dawn of the 21st Century. Oxford: Oxford University Press. pp. 267–282.
  39. Lambin EF, Turner BL, Geist HJ, Agbola SB, Angelsen A, Bruce JW, et al. (December 2001). "The causes of land-use and land-cover change: moving beyond the myths" (PDF). Global Environmental Change. 11 (4): 261–269. doi:10.1016/S0959-3780(01)00007-3.
  40. Liu J, Hull V, Batistella M, DeFries R, Dietz T, Fu F, et al. (June 2013). "Framing sustainability in a telecoupled world". Ecology and Society. 18 (2). doi:10.5751/ES-05873-180226. hdl: 10535/9132 . S2CID   8461510.
  41. Turner II BL, Meyer W (1994). "Global Land-Use and Land-Cover Change: An Overview.". In Meyer W, Turner II BL (eds.). Changes in Land Use and Land Cover: A Global Perspective. Cambridge: Cambridge University Press. pp. 3–9.
  42. Eakin H, DeFries R, Kerr S, Lambin EF, Liu J, Marcotullio PJ, et al. (2014). "Significance of telecoupling for exploration of land-use change.". Rethinking Global Land Use in an Urban Era. MIT Press. pp. 141–161. ISBN   978-0-262-02690-1.
  43. Liu J, Dietz T, Carpenter SR, Alberti M, Folke C, Moran E, et al. (September 2007). "Complexity of coupled human and natural systems". Science. 317 (5844): 1513–1516. Bibcode:2007Sci...317.1513L. doi:10.1126/science.1144004. PMID   17872436. S2CID   8109766.
  44. Downing TE, Ziervogel G, Patwardhan A (2003). Linking Global and Local Scenarios under Climate Change (Report). Stockholm Environment Institute. JSTOR   resrep00343.