Rapid fetal karyotype from cystic hygroma and pleural effusions

Fluid from pleural effusion (n=2) and cystic hygroma (n=7) was obtained from eight fetuses, between 13 and 32 weeks of pregnancy at the time when a conventional prenatal diagnosis procedure was carried out. As these fluids contain lymphocytes, they were processed like peripheral blood. A karyotype was obtained in 4 days in both cases of pleural effusion and in four out of seven samples of cystic hygroma. An abnormal karyotype was detected in three of the four samples of cystic hygroma: two trisomies 21 and a monosomy X. Different parameters were evaluated in order to predict the feasibility of obtaining a cytogenetic diagnosis. Our data showed that if the amount of fluid obtained was ⩾4 ml and the initial lymphocyte count (ILC) was >0.2 × 10⁶ cells/ml, a cytogenetic diagnosis was possible from an initial concentration of cultured lymphocytes )ICCL) of >0.06 × 10⁶ cells/ml.     

Prenatal sonographic diagnosis of intracranial haemorrhage: Report of a case with a sinusoidal fetal heart rate tracing,and review of the literature

The sinusoidal fetal heart rate pattern has been described in association with severe fetal anaemia, with fetal hypoxaemia, and with the administration of parenteral narcotics. Here, we report a case of decreased fetal movement in which a sinusoidal tracing was recorded. The sonographic diagnosis of a massive fetal intracranial haemorrhage was made. A non-interventive approach was taken and the fetus died soon after in utero. We review 28 previous cases in which the prenatal sonographic diagnosis of fetal intracranial haemorrhage was made, including the underlying maternal and fetal factors and neonatal outcomes. We propose that the sinusoidal tracing in this case was due to the intracranial bleed and suggest that fetal intracranial haemorrhage be considered in the sonographic evaluation of the fetus with a sinusoidal pattern.     

Prenatal diagnosis of mosaic 4p – in a fetus with trisomy 21

Mosaicism for the Wolf-Hirschhorn syndrome, del(4)(p16), is extremely rare and has not been reported in association with a numerical chromosome abnormality. We report the prenatal diagnosis of mosaic del(4)(p16) and non-mosaic trisomy 21 in a 16-week female fetus. The pregnancy ended in spontaneous abortion at 34 weeks secondary to fetal demise. The fetus had features of both 4p – and trisomy 21.     

Modal choice for transportation of hazardous materials: the case of land modes of transport of bio-ethanol in Brazil

Performance evaluation is important in managing freight transport. The transport of certain products, especially those that are hazardous, can have significant financial and socio-environmental impacts. This article presents an application of the modal choice method (MCM) to establish an order of priority among the alternatives considered to carry a determined hazardous product. After a research of the literature on the concepts and development of the proposed method, we consulted experts about their experiences and knowledge, to determine a set of relevant attributes for the evaluation process. We then applied this method to the specific case of the Brazilian bio-ethanol industry, to demonstrate the potential of using the MCM as a tool to support make decisions. We can conclude that highway transport, though the most often used, is not the best compared to trains or pipelines (or combinations of any of the three) from a socio-environmental standpoint. Alternatives with longer pipeline segments are the most suitable to replace the current practice in environmental terms.     

A Bayesian assessment of the effect of highway bypasses in Iowa on crashes and crash rate

Introduction

A common contention is that the construction of highway bypasses negatively impacts the economy of local communities by reducing pass-by traffic for businesses. However, as access to specific business' account records is limited, this impact is difficult to quantify. Another common contention is that bypasses contribute to a reduction in overall crashes in the community and in the surrounding areas. Even though a large number of bypasses have been constructed in the State of Iowa over the past several years, their actual impact in terms of traffic safety has not been quantified.

Objectives

This study seeks answers to the following questions: (a) Are bypasses in Iowa associated with a reduction in crash frequencies and crash rates on the bypassed highway? (b) Do bypasses in Iowa introduce a reduction of overall crash frequencies and rates or do they merely shift crashes from the highways through the communities to the bypasses with no significant overall reduction?

Method

We obtained crash information from the Iowa DOT at 19 sites on which a bypass was constructed sometime during the past 23 years. We also obtained the same information at six sites used as comparison sites on which no bypasses were constructed at least until 2005. We them employed a Bayesian approach to estimating the association between the construction of the bypass and crash rates, while also accounting for other factors.

Results

The construction of bypasses in Iowa is associated with a significant increase in traffic safety both on the main road through town and on the combined main road and bypass roadway.     

Development of an indirect-cost calculation model suitable for workplace use

Introduction: Occupational Health and Safety (OHS) stakeholders rarely factor the cost of workplace accidents into prevention spending decisions. The lack of consideration of this key information is related to the fact that the scientific literature has failed to provide OHS stakeholders with a cost-calculation tool that is both sufficiently accurate and does not require a data-collection stage ill-suited to the time constraints of workplace decision-makers. Method: This study reviews the recent literature to identify key elements that should foster the use of indirect-cost calculation methods by decision makers. Results: A “local” approach currently appears to be the best method for calculating indirect costs of workplace incidents or accidents in comparison to “bottom-up” or “top-down” approach. This paper discusses four criteria that this type of approach must satisfy to be compatible with the time constraints and accuracy demands of OHS stakeholders in organizations. In addition, four bases for the development of a new indirect cost estimation model are presented and discussed. Impact on industry: this study provides bases and criteria to help the development of indirect-cost calculation models better suited to workplace use than those currently available.