Prenatal diagnosis of genetic microcephaly

True microcephaly can be diagnosed at an early stage of gestation by serial measurements of fetal head growth as demonstrated by this case report in which the diagnosis of genetic microcephaly was made but termination refused. True microcephaly was evident at birth.     

Genetic amniocentesis in biamniotic twin pregnancies by a single transabdominal insertion of the needle

We present a technique to aspirate amniotic fluid from both sacs in biamniotic twin pregnancies using a single abdominal insertion with a spinal needle. It was successful in 48 out of 55 cases of biamniotic twin pregnancies referred to our perinatal unit between 1985 and 1994. The single insertion technique was used when the inter-amniotic membrane was clearly evident and two separate free amniotic fluid pools could be reached by the operator with a single puncture. An adequate amount of amniotic fluid was sampled from both sacs to make a cytogenetic diagnosis in all cases. There were four fetuses with trisomy 21 in three twin pregnancies. In two cases, only one twin was affected whilst the co-twin was normal, so that a selective feticide was performed. No miscarriages due to genetic amniocentesis were reported. After 1990, all genetic amniocenteses in biamniotic twin pregnancies (except for one case due to late booking) were performed between 14 and 15 weeks of gestation and with all cases except one, it was possible to sample both twins by a single puncture. We suggest that early amniocentesis (14–15 weeks) by a single abdominal puncture could be a reliable and safe alternative to first-trimester chorionic villus sampling in twin pregnancies.     

Prenatal diagnosis of Freeman–Sheldon syndrome (whistling face)

The diagnosis of Freeman–Sheldon syndrome was made by ultrasonographic evaluation of a 20-week fetus with a positive family history. The ultrasonographic features were abnormalities of the extremities and mouth.     

Thyroid antibodies are not a risk factor for pregnancies with down syndrome

The observation that thyroid disease is frequent in mothers of children with Down syndrome (DS) has suggested that maternal thyroid antibodies could be a factor predisposing to trisomy 21 in their offspring. In this study, the incidences of thyroglobulin (Tg) and thyroid peroxidase (TPO) antibodies were analysed with a sensitive solid-phase immunosorbent radioassay in sera from 29 mothers giving birth to children with trisomy 21 and 87 control mothers. The serum samples were collected at delivery. There was no statistical difference regarding the proportion of thyroid antibodies (against Tg and/or TPO) in the two groups. Thyroid antibodies were detected in 6/29 (20.7 per cent) of the DS mothers and in 23/87 (26.4 per cent) of the control mothers. Among the women with thyroid antibodies, 4/6 (66.7 per cent) of the DS mothers and 12/23 (52 per cent) of the control mothers had antibodies against both Tg and TPO. There was no increase in the relative risk of having a child with DS if the titre of either Tg or TPO antibodies or both were positive, i.e. ≥ 1/5. The results indicate that the presence of thyroid antibodies in the serum of a pregnant woman has no prognostic value for the birth of an infant with DS.     

Use of coatings to minimise acid emissions during ceramic tile firing

The manufacture of traditional ceramic products (ceramic tiles, roof tiles, and bricks) is often associated with the emission of F, Cl, and S compounds during the firing stage. According to the literature, fluorine emissions can be reduced by adding CaCO₃ to the raw materials mixture used in fabricating these products. However, data available to the authors indicate that this procedure, which has been successfully applied in manufacturing structural ceramics (roof tiles and bricks), is ineffective in ceramic tile manufacture and modifies tile end properties.This paper examines the possibility of reducing such emissions by applying coatings of alkaline-earth carbonates on to the ceramic tile bottom surface to retain the acid compounds emitted during tile firing. The effectiveness of MgCO₃, CaCO₃, SrCO₃, and BaCO₃ coatings for retaining these acid emissions was studied, using the evolved gas analysis (EGA) technique with a TG-DSC-FTIR-QM instrument.The SrCO₃ coating was found to provide the greatest retention, showing that SO₂ and HCl were retained more efficiently than HF. The presence of fluorides, chlorides, and sulphates of Ca, Sr, and Ba was verified in the respective fired coatings, confirming the existence of chemical reactions between the emitted acid compounds and the coating materials at high temperature.     

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.     

On-road and simulated driving: concurrent and discriminant validation

Introduction

A converging pair of studies investigated the validity of a simulator for measuring driving performance/skill.

Study 1

A concurrent validity study compared novice driver performance during an on-road driving test with their performance on a comparable simulated driving test.

Results

Results showed a reasonable degree of concordance in terms of the distribution of driving errors on-road and errors on the simulator. Moreover, there was a significant relationship between the two when driver performance was rank ordered according to errors, further establishing the relative validity of the simulator. However, specific driving errors on the two tasks were not closely related suggesting that absolute validity could not be established and that overall performance is needed to establish the level of skill.

Study 2

A discriminant validity study compared driving performance on the simulator across three groups of drivers who differ in their level of experience - a group of true beginners who had no driving experience, a group of novice drivers who had completed driver education and had a learner's permit, and a group of fully licensed, experienced drivers.

Results

The findings showed significant differences among the groups in the expected direction -- the various measures of driving errors showed that beginners performed worse than novice drivers and that experienced drivers had the fewest errors. Collectively, the results of the concurrent and discriminant validity studies support the use of the simulator as a valid measure of driving performance for research purposes.

Impact on industry

These findings support the use of a driving simulator as a valid measure of driving performance for research purposes. Future research should continue to examine validity between on-road driving performance and performance on a driving simulator and the use of simulated driving tests in the evaluation of driver education/training programs.