Prenatal detection of aortic coarctation in a well-organized screening setting: Are we there yet?

Objective

We aimed to assess current prenatal detection rate (DR) of aortic coarctation (CoA) and its impact on neonatal outcome in the Netherlands to evaluate the efficacy of the Dutch screening protocol in which the cardiac four-chamber view, outflow tracts and three-vessel view are compulsory.

Methods

All prenatally and postnatally diagnosed CoA cases between 2012 and 2021 were extracted from our PRECOR-registry. Annual DRs were calculated with a focus on the trend over time and attributing factors for detection. Postnatal outcome was compared between prenatally detected and undetected cases.

Results

49/116 cases (42.2%) were detected prenatally. A higher chance of detection was found for cases with extracardiac malformations (71.4%; p = 0.001) and the more severe cases with an aortic arch hypoplasia and/or ventricular septal defect (63.2%; p = 0.001). Time-trend analysis showed no improvement in DR over time (p = 0.33). Undetected cases presented with acute circulatory shock in 20.9% and were more likely to have severe lactic acidosis (p = 0.02) and impaired cardiac function (p < 0.001) before surgery.

Conclusion

Even in a well-organized screening program, the DR of CoA still requires improvement, especially in isolated cases. The increased risk of severe lactic acidosis in undetected cases stresses the need for urgent additions to the current screening program, such as implementation of the three-vessel trachea view and measurement of outflow tracts.     

The electro-oxidation of tetracycline hydrochloride in commercial DSA® modified by electrodeposited platinum

Environmental Science and Pollution Research - Tetracycline hydrochloride (TCH) electro-oxidation by commercial DSA® and commercial DSA® modified by platinum electrodeposition was...     

Effects of increased sea water concentrations of CO2 on growth of the bivalve Mytilus edulis L

It has been proposed that emission of anthropogenic carbon dioxide to the atmosphere will lead to increased concentrations of CO(2) in sea water corresponding to a decrease of pH of several tenths of pH units. An experiment was performed to test the effects of increased sea water concentrations of CO(2) on shell growth of the blue mussel Mytilus edulis. The experiment was performed in aquaria continuously flushed with sea water spiked with CO(2) to provide five different levels of pH between 6.7 and control sea water with a pH of 8.1. The shell length of the mussels was measured at the start and end of the 44 days experimental period. No mortality was observed during the first 23 days of the experiment. The growth increment in mm was much larger for small mussels than for large mussels, but relative growth profile as function of pH was more similar in the two size groups; observed differences may be random variation between samples. The experiments showed that CO(2) induced reduction of pH affects the growth of M. edulis negatively. There was a strong and statistically significant decrease in growth at the lowest pH values, with virtually no growth at pH = 6.7 and reduced growth at pH = 7.1. The effect seems to set in between pH 7.4 and 7.1; at mean pH levels 7.4 and 7.6 the growth increments were not significantly different from growth at normal pH 8.1.     

Associations between sleep,risk and safety climate: A study of offshore personnel on the Norwegian continental shelf

The demands and constraints of the offshore working environment can have adverse effects on health, particularly the quality of sleep. Perceived risk and safety are significant psychological stress factors which may interfere with and deteriorate the sleep quality of offshore personnel. The present study explores the relationship between risk perception, safety climate and sleep quality. Data were collected under the auspices of the Petroleum Safety Authorities in Norway using a cross-sectional design. A total of 9601 offshore workers from 52 offshore installations on the Norwegian continental shelf participated in the study. Our findings indicate that both risk perception and safety climate are significantly related to sleep quality. The results of the present study suggest that risk perception and safety climate not only are important aspects of safety performance in the offshore industry, but also have an impact on sleep quality.