Ultrasound diagnostic features of twin reversed arterial perfusion sequence

Two cases of twin reversed arterial perfusion (TRAP) sequence with relevant ultrasound features that would help an accurate diagnosis are described. Available management options are proposed and discussed.     

Local opposition against high-voltage grids: public responses to agency-caused science–policy trolls

High-voltage (hV) transmission grids are projects of societal importance that potentially have controversial social and environmental impacts. Former research shows that public opposition is sparked by the perception of negative local impacts and unjust concessionary processes. In this paper, we complement these perspectives by assessing the institutional practices of the regulatory agencies in dealing with scientific uncertainties. The regulatory agencies’ ‘ways of doing things’ are often designed to serve policy and management needs. A critical point is that the demarcation between scientifically based facts, values and assessments is often blurred in the decision-making process. This paper draws on two Norwegian case studies to investigate how the regulatory agencies dealt with (1) electromagnetic fields and health risks and (2) overhead lines versus sea cables. We argue that ambiguities and uncertainties that arise in the hV transmission line processes create ‘trolls’, and we explore how the local inhabitants and affected stakeholders in the two cases responded to these and how it triggered further opposition. By investigating how and why trolls appear and are handled, we conclude by discussing how public opposition related to hV transmission grids may be reduced – and how some ‘trolls’ may crack.     

The normal fetus of an acardiac twin pregnancy: Perinatal management based on echocardiographic and sonographic evaluation

Experience with three prenatally diagnosed pregnancies complicated by an acardiac twin reveals that ultrasonography and echocardiography are helpful in detecting early signs of in-utero congestive heart failure in the normal twin. The use of Doppler blood flow analysis to determine direction of blood flow, post-mortem placental and fetal angiography, and umbilical cord blood gas determination provided proof that retrograde arterial perfusion occurs in the acardiac fetus. In a fourth pregnancy, an experimental approach to occlude the acardiac twin's umbilical cord was attempted, but was unsuccessful.