Etiology and management of early pregnancy renal anhydramnios: Is there a place for serial amnioinfusions?

Early pregnancy renal anhydramios (EPRA) comprises congenital renal disease that results in fetal anhydramnios by 22 weeks of gestation. It occurs in over 1 in 2000 pregnancies and affects 1500 families in the US annually. EPRA was historically considered universally fatal due to associated pulmonary hypoplasia and neonatal respiratory failure. There are several etiologies of fetal renal failure that result in EPRA including bilateral renal agenesis, cystic kidney disease, and lower urinary tract obstruction. Appropriate sonographic evaluation is required to arrive at the appropriate urogenital diagnosis and to identify additional anomalies that allude to a specific genetic diagnosis. Genetic evaluation variably includes karyotype, microarray, targeted gene testing, panels, or whole exome sequencing depending on presentation. Patients receiving a fetal diagnosis of EPRA should be offered management options of pregnancy termination or perinatal palliative care, with the option of serial amnioinfusion therapy offered on a research basis. Preliminary data from case reports demonstrate an association between serial amnioinfusion therapy and short-term postnatal survival of EPRA, with excellent respiratory function in the neonatal period. A multicenter trial, the renal anhydramnios fetal therapy (RAFT) trial, is underway. We sought to review the initial diagnosis ultrasound findings, genetic etiologies, and current management options for EPRA.     

Innovations in the water chain – experiences in The Netherlands

Innovations in water chain are discussed based on experiences in the Netherlands. The available and new technological options, as well as their dissemination in the Netherlands, are presented for the prevailing system with add-on technologies (elongation), and for the emerging separation system with technologies at the source. Numerous new options are available for both systems but these options are rarely used. The low use is explained using economic theories and with practical examples from the Netherlands. In order to foster innovations, the mainstream, evolutionary, and behavioral theories pinpoint respectively the pricing of common goods, broad support of concerted action, and support for innovators’ entry. These actions may all be needed. Experiences with a stakeholder cluster in water management suggest that markets for high value water use invoke innovations and low-cost technology adaptations. The systematic development of services that foster high value water-based activities is recommended.     

Fetoscopic tracheal occlusion for treatment of non-isolated congenital diaphragmatic hernia

Fetoscopic endotracheal occlusion (FETO) is a prenatal treatment that may increase survival in severe congenital diaphragmatic hernia (CDH). In the USA, FETO is offered for isolated severe left-sided CDH in the context of an FDA-approved feasibility study. FETO in non-isolated cases of severe CDH is only performed with a compassionate use exemption from US regulatory bodies. Anomalies frequently associated with CDH include congenital cystic lesions of the lung and cardiac defects. We describe two cases of non-isolated severe left-sided CDH that underwent prenatal FETO, survived after birth and underwent postnatal surgical repair. The potential benefit of FETO in this setting is discussed. © 2017 John Wiley & Sons, Ltd.     

Stochastic Transfer Function Model and Neural Networks to Estimate Soil Moisture1

Abstract: A practical methodology is proposed to estimate the three‐dimensional variability of soil moisture based on a stochastic transfer function model, which is an approximation of the Richard’s equation. Satellite, radar and in situ observations are the major sources of information to develop a model that represents the dynamic water content in the soil. The soil‐moisture observations were collected from 17 stations located in Puerto Rico (PR), and a sequential quadratic programming algorithm was used to estimate the parameters of the transfer function (TF) at each station. Soil texture information, terrain elevation, vegetation index, surface temperature, and accumulated rainfall for every grid cell were input into a self‐organized artificial neural network to identify similarities on terrain spatial variability and to determine the TF that best resembles the properties of a particular grid point. Soil moisture observed at 20 cm depth, soil texture, and cumulative rainfall were also used to train a feedforward artificial neural network to estimate soil moisture at 5, 10, 50, and 100 cm depth. A validation procedure was implemented to measure the horizontal and vertical estimation accuracy of soil moisture. Validation results from spatial and temporal variation of volumetric water content (vwc) showed that the proposed algorithm estimated soil moisture with a root mean squared error (RMSE) of 2.31% vwc, and the vertical profile shows a RMSE of 2.50% vwc. The algorithm estimates soil moisture in an hourly basis at 1 km spatial resolution, and up to 1 m depth, and was successfully applied under PR climate conditions.     

Evaluating Alternative Temporal Survey Designs for Monitoring Wetland Area and Detecting Changes Over Time in California

Evaluation of wetland extent and changes in extent is a foundation of many wetland monitoring and assessment programs. Probabilistic sampling and mapping provides a cost‐effective alternative to comprehensive mapping for large geographic areas. One unresolved challenge for probabilistic or design‐based approaches is how best to monitor both status (e.g., extent at a single point in time) and trends (e.g., changes in extent over time) within a single monitoring program. Existing wetland status and trends (S&T) monitoring programs employ fixed sampling locations; however, theoretical evaluation and limited implementation in other landscape monitoring areas suggest that alternative designs could increase statistical efficiency and overall accuracy. In particular, designs that employ both fixed and nonfixed sampling locations (alternately termed permanent and temporary samples), termed sampling with partial replacement (SPR), are considered to efficiently and effectively balance monitoring current status with detection of trends. This study utilized simulated sampling to assess the performance of fixed sampling locations, SPR, and strictly nonfixed designs for monitoring wetland S&T over time. Modeled changes in wetland density over time were used as inputs for sampling simulations. In contrast to previous evaluations of SPR, the results of this study support the use of a fixed sampling design and show that SPR may underestimate both S&T.     

Efficacy of Vegetated Buffers in Preventing Transport of Fecal Coliform Bacteria from Pasturelands

An experimental study was conducted in Tillamook, Oregon, USA, to quantify the effectiveness of edge-of-field vegetated buffers for reducing transport of fecal coliform bacteria (FCB) from agricultural fields amended with dairy cow manure. Installation of vegetated buffers on loamy soils dramatically reduced the bacterial contamination of runoff water from manure-treated pasturelands, but the size of the vegetated buffer was not an important determinant of bacterial removal efficiency. Only 10% of the runoff samples collected from treatment cells having vegetated buffers exhibited FCB concentrations >200 colony forming units (cfu)/100 mL (a common water quality standard value), and the median concentration for all cells containing vegetated buffers was only 6 cfu/100 mL. The presence of a vegetated buffer of any size, from 1 to 25 m, generally reduced the median FCB concentration in runoff by more than 99%. Results for FCB load calculations were similar. Our results suggest that where substantial FCB contamination of runoff occurs from manure-treated pasturelands, it might be disproportionately associated with specific field or management conditions, such as the presence of soils that exhibit low water infiltration and generate larger volumes of runoff or the absence of a vegetated buffer. Buffer size regulations that do not consider such differences might not be efficient or effective in reducing bacterial contamination of runoff.