Epidemiologic Studies
Studies designed to examine associations, commonly, hypothesized causal relations. They are usually concerned with identifying or measuring the effects of risk factors or exposures. The common types of analytic study are CASE-CONTROL STUDIES; COHORT STUDIES; and CROSS-SECTIONAL STUDIES.
Epidemiologic Methods
Risk Factors
An aspect of personal behavior or lifestyle, environmental exposure, or inborn or inherited characteristic, which, on the basis of epidemiologic evidence, is known to be associated with a health-related condition considered important to prevent.
Epidemiologic Research Design
Environmental Exposure
Epidemiology
Field of medicine concerned with the determination of causes, incidence, and characteristic behavior of disease outbreaks affecting human populations. It includes the interrelationships of host, agent, and environment as related to the distribution and control of disease.
United States
The term "United States" in a medical context often refers to the country where a patient or study participant resides, and is not a medical term per se, but relevant for epidemiological studies, healthcare policies, and understanding differences in disease prevalence, treatment patterns, and health outcomes across various geographic locations.
Incidence
The number of new cases of a given disease during a given period in a specified population. It also is used for the rate at which new events occur in a defined population. It is differentiated from PREVALENCE, which refers to all cases, new or old, in the population at a given time.
Bias (Epidemiology)
Any deviation of results or inferences from the truth, or processes leading to such deviation. Bias can result from several sources: one-sided or systematic variations in measurement from the true value (systematic error); flaws in study design; deviation of inferences, interpretations, or analyses based on flawed data or data collection; etc. There is no sense of prejudice or subjectivity implied in the assessment of bias under these conditions.
Occupational Exposure
Case-Control Studies
Studies which start with the identification of persons with a disease of interest and a control (comparison, referent) group without the disease. The relationship of an attribute to the disease is examined by comparing diseased and non-diseased persons with regard to the frequency or levels of the attribute in each group.
Epidemiological Monitoring
Collection, analysis, and interpretation of data about the frequency, distribution, and consequences of disease or health conditions, for use in the planning, implementing, and evaluating public health programs.
Depression
Depressive states usually of moderate intensity in contrast with major depression present in neurotic and psychotic disorders.
Confounding Factors (Epidemiology)
Factors that can cause or prevent the outcome of interest, are not intermediate variables, and are not associated with the factor(s) under investigation. They give rise to situations in which the effects of two processes are not separated, or the contribution of causal factors cannot be separated, or the measure of the effect of exposure or risk is distorted because of its association with other factors influencing the outcome of the study.
Cohort Studies
Studies in which subsets of a defined population are identified. These groups may or may not be exposed to factors hypothesized to influence the probability of the occurrence of a particular disease or other outcome. Cohorts are defined populations which, as a whole, are followed in an attempt to determine distinguishing subgroup characteristics.
Prevalence
The total number of cases of a given disease in a specified population at a designated time. It is differentiated from INCIDENCE, which refers to the number of new cases in the population at a given time.
Risk
Air Pollutants
Any substance in the air which could, if present in high enough concentration, harm humans, animals, vegetation or material. Substances include GASES; PARTICULATE MATTER; and volatile ORGANIC CHEMICALS.
Questionnaires
Environmental Monitoring
Molecular Epidemiology
The application of molecular biology to the answering of epidemiological questions. The examination of patterns of changes in DNA to implicate particular carcinogens and the use of molecular markers to predict which individuals are at highest risk for a disease are common examples.
Wisconsin
whoa, buddy! I'm just a friendly AI and I don't have access to real-time databases or personal data, so I can't provide medical definitions or any other specific information about individuals, places, or things. But I can tell you that I couldn't find any recognized medical definition for "Wisconsin" - it's a state in the United States, not a medical term!
Epidemiologic Factors
Reproducibility of Results
The statistical reproducibility of measurements (often in a clinical context), including the testing of instrumentation or techniques to obtain reproducible results. The concept includes reproducibility of physiological measurements, which may be used to develop rules to assess probability or prognosis, or response to a stimulus; reproducibility of occurrence of a condition; and reproducibility of experimental results.
Risk Assessment
The qualitative or quantitative estimation of the likelihood of adverse effects that may result from exposure to specified health hazards or from the absence of beneficial influences. (Last, Dictionary of Epidemiology, 1988)
Neoplasms
Prospective Studies
Japan
## I'm sorry for any confusion, but "Japan" is not a medical term or concept. It is a country located in Asia, known as Nihon-koku or Nippon-koku in Japanese, and is renowned for its unique culture, advanced technology, and rich history. If you have any questions related to medical topics, I would be happy to help answer them!
Cross-Sectional Studies
Studies in which the presence or absence of disease or other health-related variables are determined in each member of the study population or in a representative sample at one particular time. This contrasts with LONGITUDINAL STUDIES which are followed over a period of time.
Pesticides
Epidemiologic Study Characteristics as Topic
Disease Outbreaks
Sudden increase in the incidence of a disease. The concept includes EPIDEMICS and PANDEMICS.
Southwestern United States
The geographic area of the southwestern region of the United States. The states usually included in this region are Arizona, California, Colorado, Nevada, New Mexico, Texas, and Utah.
Odds Ratio
The ratio of two odds. The exposure-odds ratio for case control data is the ratio of the odds in favor of exposure among cases to the odds in favor of exposure among noncases. The disease-odds ratio for a cohort or cross section is the ratio of the odds in favor of disease among the exposed to the odds in favor of disease among the unexposed. The prevalence-odds ratio refers to an odds ratio derived cross-sectionally from studies of prevalent cases.
Age Factors
Age as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or the effect of a circumstance. It is used with human or animal concepts but should be differentiated from AGING, a physiological process, and TIME FACTORS which refers only to the passage of time.
Population Surveillance
Sex Factors
Maleness or femaleness as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or effect of a circumstance. It is used with human or animal concepts but should be differentiated from SEX CHARACTERISTICS, anatomical or physiological manifestations of sex, and from SEX DISTRIBUTION, the number of males and females in given circumstances.
Causality
The relating of causes to the effects they produce. Causes are termed necessary when they must always precede an effect and sufficient when they initiate or produce an effect. Any of several factors may be associated with the potential disease causation or outcome, including predisposing factors, enabling factors, precipitating factors, reinforcing factors, and risk factors.
Longitudinal Studies
Effect Modifier, Epidemiologic
Environmental Pollutants
Research Design
Logistic Models
Statistical models which describe the relationship between a qualitative dependent variable (that is, one which can take only certain discrete values, such as the presence or absence of a disease) and an independent variable. A common application is in epidemiology for estimating an individual's risk (probability of a disease) as a function of a given risk factor.
Connecticut
I'm sorry for any confusion, but "Connecticut" is a state located in the northeastern region of the United States and does not have a medical definition. If you have any questions related to medicine or health, I would be happy to try to help answer those!
Air Pollution
The presence of contaminants or pollutant substances in the air (AIR POLLUTANTS) that interfere with human health or welfare, or produce other harmful environmental effects. The substances may include GASES; PARTICULATE MATTER; or volatile ORGANIC CHEMICALS.
Health Surveys
Iowa
I'm sorry for any confusion, but "Iowa" is a state located in the Midwestern United States and does not have a medical definition.
Mexican Americans
Persons living in the United States of Mexican descent.
Water Supply
Radon
Particulate Matter
Models, Statistical
Pregnancy
Confidence Intervals
Regression Analysis
Procedures for finding the mathematical function which best describes the relationship between a dependent variable and one or more independent variables. In linear regression (see LINEAR MODELS) the relationship is constrained to be a straight line and LEAST-SQUARES ANALYSIS is used to determine the best fit. In logistic regression (see LOGISTIC MODELS) the dependent variable is qualitative rather than continuously variable and LIKELIHOOD FUNCTIONS are used to find the best relationship. In multiple regression, the dependent variable is considered to depend on more than a single independent variable.
Age Distribution
Carotenoids
The general name for a group of fat-soluble pigments found in green, yellow, and leafy vegetables, and yellow fruits. They are aliphatic hydrocarbons consisting of a polyisoprene backbone.
California
I'm sorry for any confusion, but "California" is a place, specifically a state on the western coast of the United States, and not a medical term or concept. Therefore, it doesn't have a medical definition.
Follow-Up Studies
Nuts
Botanically, a type of single-seeded fruit in which the pericarp enclosing the seed is a hard woody shell. In common usage the term is used loosely for any hard, oil-rich kernel. Of those commonly eaten, only hazel, filbert, and chestnut are strictly nuts. Walnuts, pecans, almonds, and coconuts are really drupes. Brazil nuts, pistachios, macadamias, and cashews are really seeds with a hard shell derived from the testa rather than the pericarp.
Acrylonitrile
European Continental Ancestry Group
Individuals whose ancestral origins are in the continent of Europe.
Inhalation Exposure
Genotype
Psychiatric Status Rating Scales
Depressive Disorder
Carcinogens
North Carolina
(Note: 'North Carolina' is a place, not a medical term. However, I can provide a fun fact related to health and North Carolina.)
Soy Foods
Foods made from SOYBEANS. Health benefits are ascribed to the high levels of DIETARY PROTEINS and ISOFLAVONES.
Air Pollutants, Occupational
Biological Markers
Measurable and quantifiable biological parameters (e.g., specific enzyme concentration, specific hormone concentration, specific gene phenotype distribution in a population, presence of biological substances) which serve as indices for health- and physiology-related assessments, such as disease risk, psychiatric disorders, environmental exposure and its effects, disease diagnosis, metabolic processes, substance abuse, pregnancy, cell line development, epidemiologic studies, etc.
Agricultural Workers' Diseases
Diseases in persons engaged in cultivating and tilling soil, growing plants, harvesting crops, raising livestock, or otherwise engaged in husbandry and farming. The diseases are not restricted to farmers in the sense of those who perform conventional farm chores: the heading applies also to those engaged in the individual activities named above, as in those only gathering harvest or in those only dusting crops.
Cardiovascular Diseases
Sex Distribution
Maximum Allowable Concentration
The maximum exposure to a biologically active physical or chemical agent that is allowed during an 8-hour period (a workday) in a population of workers, or during a 24-hour period in the general population, which does not appear to cause appreciable harm, whether immediate or delayed for any period, in the target population. (From Lewis Dictionary of Toxicology, 1st ed)
Specimen Handling
Washington
#### My apologies, but the term 'Washington' is not a medical concept or condition that has a defined meaning within the medical field. It refers to various concepts, primarily related to the U.S. state of Washington or the District of Columbia, where the nation's capital is located. If you have any questions about medical topics or conditions, please feel free to ask!
Proportional Hazards Models
Air Pollution, Radioactive
Radioactive air pollution refers to the presence and circulation of radioactive particles or gases in the atmosphere, originating from human activities such as nuclear power plant accidents, nuclear weapons testing, or improper disposal of radioactive waste, which can pose significant health risks to living organisms due to ionizing radiation exposure.
Comorbidity
The presence of co-existing or additional diseases with reference to an initial diagnosis or with reference to the index condition that is the subject of study. Comorbidity may affect the ability of affected individuals to function and also their survival; it may be used as a prognostic indicator for length of hospital stay, cost factors, and outcome or survival.
Data Interpretation, Statistical
Agrochemicals
Chemicals used in agriculture. These include pesticides, fumigants, fertilizers, plant hormones, steroids, antibiotics, mycotoxins, etc.
Sensitivity and Specificity
Binary classification measures to assess test results. Sensitivity or recall rate is the proportion of true positives. Specificity is the probability of correctly determining the absence of a condition. (From Last, Dictionary of Epidemiology, 2d ed)
Alcohol Drinking
Behaviors associated with the ingesting of alcoholic beverages, including social drinking.
United States Environmental Protection Agency
Public Health
Multivariate Analysis
A set of techniques used when variation in several variables has to be studied simultaneously. In statistics, multivariate analysis is interpreted as any analytic method that allows simultaneous study of two or more dependent variables.
Socioeconomic Factors
Vehicle Emissions
Postmenopause
African Americans
Persons living in the United States having origins in any of the black groups of Africa.
Genetic Predisposition to Disease
Seasons
Diet Surveys
Systematic collections of factual data pertaining to the diet of a human population within a given geographic area.
Maternal Exposure
Exposure of the female parent, human or animal, to potentially harmful chemical, physical, or biological agents in the environment or to environmental factors that may include ionizing radiation, pathogenic organisms, or toxic chemicals that may affect offspring. It includes pre-conception maternal exposure.
beta Carotene
A carotenoid that is a precursor of VITAMIN A. It is administered to reduce the severity of photosensitivity reactions in patients with erythropoietic protoporphyria (PORPHYRIA, ERYTHROPOIETIC). (From Reynolds JEF(Ed): Martindale: The Extra Pharmacopoeia (electronic version). Micromedex, Inc, Engewood, CO, 1995.)
Tea
The infusion of leaves of CAMELLIA SINENSIS (formerly Thea sinensis) as a beverage, the familiar Asian tea, which contains CATECHIN (especially epigallocatechin gallate) and CAFFEINE.
Data Collection
Systematic gathering of data for a particular purpose from various sources, including questionnaires, interviews, observation, existing records, and electronic devices. The process is usually preliminary to statistical analysis of the data.
Environmental Health
Registries
Industry
Neoplasms, Radiation-Induced
Tumors, cancer or other neoplasms produced by exposure to ionizing or non-ionizing radiation.
Retrospective Studies
Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.
Respiratory Tract Diseases
Linear Models
Costa Rica
('Costa Rica' in medical context is not a defined term) However, in general context, Costa Rica is a country located in Central America, known for its advanced healthcare system and high life expectancy, which could be relevant to various medical or health-related discussions.
Chemical Industry
Body Mass Index
An indicator of body density as determined by the relationship of BODY WEIGHT to BODY HEIGHT. BMI=weight (kg)/height squared (m2). BMI correlates with body fat (ADIPOSE TISSUE). Their relationship varies with age and gender. For adults, BMI falls into these categories: below 18.5 (underweight); 18.5-24.9 (normal); 25.0-29.9 (overweight); 30.0 and above (obese). (National Center for Health Statistics, Centers for Disease Control and Prevention)
Polymerase Chain Reaction
In vitro method for producing large amounts of specific DNA or RNA fragments of defined length and sequence from small amounts of short oligonucleotide flanking sequences (primers). The essential steps include thermal denaturation of the double-stranded target molecules, annealing of the primers to their complementary sequences, and extension of the annealed primers by enzymatic synthesis with DNA polymerase. The reaction is efficient, specific, and extremely sensitive. Uses for the reaction include disease diagnosis, detection of difficult-to-isolate pathogens, mutation analysis, genetic testing, DNA sequencing, and analyzing evolutionary relationships.
Texas
Arsenic
A shiny gray element with atomic symbol As, atomic number 33, and atomic weight 75. It occurs throughout the universe, mostly in the form of metallic arsenides. Most forms are toxic. According to the Fourth Annual Report on Carcinogens (NTP 85-002, 1985), arsenic and certain arsenic compounds have been listed as known carcinogens. (From Merck Index, 11th ed)
Chronic Disease
Diseases which have one or more of the following characteristics: they are permanent, leave residual disability, are caused by nonreversible pathological alteration, require special training of the patient for rehabilitation, or may be expected to require a long period of supervision, observation, or care. (Dictionary of Health Services Management, 2d ed)
Benzene
Toxic, volatile, flammable liquid hydrocarbon byproduct of coal distillation. It is used as an industrial solvent in paints, varnishes, lacquer thinners, gasoline, etc. Benzene causes central nervous system damage acutely and bone marrow damage chronically and is carcinogenic. It was formerly used as parasiticide.
Beverages
Ozone
The unstable triatomic form of oxygen, O3. It is a powerful oxidant that is produced for various chemical and industrial uses. Its production is also catalyzed in the ATMOSPHERE by ULTRAVIOLET RAY irradiation of oxygen or other ozone precursors such as VOLATILE ORGANIC COMPOUNDS and NITROGEN OXIDES. About 90% of the ozone in the atmosphere exists in the stratosphere (STRATOSPHERIC OZONE).
Polycyclic Hydrocarbons, Aromatic
A major group of unsaturated cyclic hydrocarbons containing two or more rings. The vast number of compounds of this important group, derived chiefly from petroleum and coal tar, are rather highly reactive and chemically versatile. The name is due to the strong and not unpleasant odor characteristic of most substances of this nature. (From Hawley's Condensed Chemical Dictionary, 12th ed, p96)
Cooking
Sweden
I'm sorry for any confusion, but "Sweden" is not a medical term and does not have a medical definition. It is a country located in Northern Europe. If you have any questions related to medical topics or definitions, I would be happy to try to help answer them!
Hawaii
A group of islands in Polynesia, in the north central Pacific Ocean, comprising eight major and 114 minor islands, largely volcanic and coral. Its capital is Honolulu. It was first reached by Polynesians about 500 A.D. It was discovered and named the Sandwich Islands in 1778 by Captain Cook. The islands were united under the rule of King Kamehameha 1795-1819 and requested annexation to the United States in 1893 when a provisional government was set up. Hawaii was established as a territory in 1900 and admitted as a state in 1959. The name is from the Polynesian Owhyhii, place of the gods, with reference to the two volcanoes Mauna Kea and Mauna Loa, regarded as the abode of the gods. (From Webster's New Geographical Dictionary, 1988, p493 & Room, Brewer's Dictionary of Names, 1992, p2330)
Evaluation Studies as Topic
Obesity
A status with BODY WEIGHT that is grossly above the acceptable or desirable weight, usually due to accumulation of excess FATS in the body. The standards may vary with age, sex, genetic or cultural background. In the BODY MASS INDEX, a BMI greater than 30.0 kg/m2 is considered obese, and a BMI greater than 40.0 kg/m2 is considered morbidly obese (MORBID OBESITY).
Maryland
I'm sorry for any confusion, but the term "Maryland" is not a recognized medical term with a specific definition in the medical field. It refers to a state in the United States. If you have any questions about a medical condition or treatment, I would be happy to try and help answer those!
Life Style
Prenatal Exposure Delayed Effects
Canada
Water Pollutants, Chemical
Refuse Disposal
France
A country in western Europe bordered by the Atlantic Ocean, the English Channel, the Mediterranean Sea, and the countries of Belgium, Germany, Italy, Spain, Switzerland, the principalities of Andorra and Monaco, and by the duchy of Luxembourg. Its capital is Paris.
Health Status
African Continental Ancestry Group
Vinyl Chloride
A gas that has been used as an aerosol propellant and is the starting material for polyvinyl resins. Toxicity studies have shown various adverse effects, particularly the occurrence of liver neoplasms.
Polychlorinated Biphenyls
Industrial products consisting of a mixture of chlorinated biphenyl congeners and isomers. These compounds are highly lipophilic and tend to accumulate in fat stores of animals. Many of these compounds are considered toxic and potential environmental pollutants.
Trichloroethylene
A highly volatile inhalation anesthetic used mainly in short surgical procedures where light anesthesia with good analgesia is required. It is also used as an industrial solvent. Prolonged exposure to high concentrations of the vapor can lead to cardiotoxicity and neurological impairment.
Baltimore
I'm sorry for any confusion, but the term "Baltimore" doesn't have a specific medical definition as it is commonly associated with a city in Maryland, USA, or it could refer to various unrelated medical concepts which are not substantial or standard enough to be considered as a formal medical term.
Epidemiologic Measurements
Nutrition Surveys
DNA Fingerprinting
A technique for identifying individuals of a species that is based on the uniqueness of their DNA sequence. Uniqueness is determined by identifying which combination of allelic variations occur in the individual at a statistically relevant number of different loci. In forensic studies, RESTRICTION FRAGMENT LENGTH POLYMORPHISM of multiple, highly polymorphic VNTR LOCI or MICROSATELLITE REPEAT loci are analyzed. The number of loci used for the profile depends on the ALLELE FREQUENCY in the population.
Bacterial Typing Techniques
Formaldehyde
A highly reactive aldehyde gas formed by oxidation or incomplete combustion of hydrocarbons. In solution, it has a wide range of uses: in the manufacture of resins and textiles, as a disinfectant, and as a laboratory fixative or preservative. Formaldehyde solution (formalin) is considered a hazardous compound, and its vapor toxic. (From Reynolds, Martindale The Extra Pharmacopoeia, 30th ed, p717)
Mexico
I'm sorry for any confusion, but "Mexico" is not a medical term and does not have a medical definition. It is the name of a country located in North America, known officially as the United Mexican States. If you have any questions related to medical topics or terminology, I would be happy to help answer those!
Europe
Ethnic Groups
Polymorphism, Restriction Fragment Length
Self Report
New Hampshire
I'm sorry for any confusion, but "New Hampshire" is a geographical location and not a medical term or concept, so it doesn't have a medical definition. It is a state in the northeastern United States, known for its scenic beauty and the White Mountains. If you have any questions related to health, medicine, or healthcare services in the state of New Hampshire, I would be happy to help with those!
Nutrition Assessment
Evaluation and measurement of nutritional variables in order to assess the level of nutrition or the NUTRITIONAL STATUS of the individual. NUTRITION SURVEYS may be used in making the assessment.
Diabetes Mellitus
Demography
Korea
Dietary Supplements
Products in capsule, tablet or liquid form that provide dietary ingredients, and that are intended to be taken by mouth to increase the intake of nutrients. Dietary supplements can include macronutrients, such as proteins, carbohydrates, and fats; and/or MICRONUTRIENTS, such as VITAMINS; MINERALS; and PHYTOCHEMICALS.
Records as Topic
2,4,5-Trichlorophenoxyacetic Acid
Respiratory Tract Neoplasms
Respiratory Tract Neoplasms are defined as abnormal growths or tumors that develop within the respiratory system, including the nose, sinuses, throat (pharynx), voice box (larynx), windpipe (trachea), bronchi, and lungs, which can be benign or malignant, with the potential to cause significant morbidity and mortality.
Activities of Daily Living
Seroepidemiologic Studies
Extreme Heat
High temperature weather exceeding the average and of several weeks duration. Extreme heat is a dangerous situation that can bring on health emergencies in susceptible people.
Newfoundland and Labrador
Province of Canada consisting of the island of Newfoundland and an area of Labrador. Its capital is St. John's.
Sampling Studies
Selection Bias
Isoflavones
3-Phenylchromones. Isomeric form of FLAVONOIDS in which the benzene group is attached to the 3 position of the benzopyran ring instead of the 2 position.
Databases, Factual
Extensive collections, reputedly complete, of facts and data garnered from material of a specialized subject area and made available for analysis and application. The collection can be automated by various contemporary methods for retrieval. The concept should be differentiated from DATABASES, BIBLIOGRAPHIC which is restricted to collections of bibliographic references.
Metallurgy
The science, art, or technology dealing with processes involved in the separation of metals from their ores, the technique of making or compounding the alloys, the techniques of working or heat-treating metals, and the mining of metals. It includes industrial metallurgy as well as metallurgical techniques employed in the preparation and working of metals used in dentistry, with special reference to orthodontic and prosthodontic appliances. (From Jablonski, Dictionary of Dentistry, 1992, p494)
Lead
Hypertension
Persistently high systemic arterial BLOOD PRESSURE. Based on multiple readings (BLOOD PRESSURE DETERMINATION), hypertension is currently defined as when SYSTOLIC PRESSURE is consistently greater than 140 mm Hg or when DIASTOLIC PRESSURE is consistently 90 mm Hg or more.
Severity of Illness Index
Polymorphism, Genetic
The regular and simultaneous occurrence in a single interbreeding population of two or more discontinuous genotypes. The concept includes differences in genotypes ranging in size from a single nucleotide site (POLYMORPHISM, SINGLE NUCLEOTIDE) to large nucleotide sequences visible at a chromosomal level.
Electrophoresis, Gel, Pulsed-Field
Gel electrophoresis in which the direction of the electric field is changed periodically. This technique is similar to other electrophoretic methods normally used to separate double-stranded DNA molecules ranging in size up to tens of thousands of base-pairs. However, by alternating the electric field direction one is able to separate DNA molecules up to several million base-pairs in length.
Models, Theoretical
Hispanic Americans
Persons living in the United States of Mexican (MEXICAN AMERICANS), Puerto Rican, Cuban, Central or South American, or other Spanish culture or origin. The concept does not include Brazilian Americans or Portuguese Americans.
Nitrogen Dioxide
Nitrogen oxide (NO2). A highly poisonous gas. Exposure produces inflammation of lungs that may only cause slight pain or pass unnoticed, but resulting edema several days later may cause death. (From Merck, 11th ed) It is a major atmospheric pollutant that is able to absorb UV light that does not reach the earth's surface.