Mother-to-child transmission is considered a particularly troubling element of the epidemic in South Africa, where almost a quarter of all pregnant women carry the virus.
Studies show that up to 70percentt of gay and bisexual men with syphilis will test positive for H.I.V. "Obviously, that's a very troubling element and heightens our activities focusing on these groups," Dr. George Counts, director of the agency's syphilis elimination activities, said.
The troubling element, from a corporate governance perspective, is that Thomas Cook's board had no power to reduce Green's award itself to reflect damage to the company's reputation.
Perhaps the most troubling element was finding a pro cess of population churning in which a neighborhood that had seemed to be ideally in tegrated was losing almost all its whites after years of apparently futile effort to maintain an ethnic mix.
One troubling element of last July's peace agreement was a broad amnesty granted to rebel fighters for crimes committed during the war.
But many of the groups that spend time on the water agree: the largest and most troubling element of the whale's trajectory to extinction is the disappearance of Chinook salmon – known by anglers as the "king salmon".
But the more troubling element of Bodega is that it wants to render its namesake obsolete.
The descriptors applied to Dunham's body are, surprisingly, not the most troubling element of Stasi's piece.
The most troubling element of this new poverty is what we label the growing "compassion gap" toward those in need between Democrats and Republicans.
Another possibly troubling element is the seeming indifference that Lange's character, Margaret Lewin, displays to her adoptive child's African American cultural heritage and the suggestion that blacks alone can best impart this heritage.
