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This prospective study investigates the relationship between insulin-dependent diabetes and maternal serum levels of alpha-fetoprotein (AFP), unconjugated oestriol (uE3), and human chorionic gonadotropin (hCG). It also examines the potential impact on screening for Down syndrome. The population-based cohort included 20 321 pregnant women in Maine who underwent routine serum screening for Down syndrome in the second trimester. The cohort included 52 women with insulin-dependent diabetes. Maternal serum AFP levels are now routinely adjusted for insulin-dependent diabetes. These adjustments, therefore, were made routinely in the diabetic women, but no equivalent adjustments were made for uE3 and hCG values. The initial false-positive rate (using all three markers) among the women with diabetes was not significantly different from that in the non-diabetic population (7·7 and 5·4 per cent, respectively). Prior to adjustment for insulin-dependent diabetes, the median AFP level in the 52 women was 0·73 multiples of the median (MOM); the median levels of uE3 and hCG were 0·93 and 0·98 MOM, respectively. When the uE3 and hCG levels were adjusted, the initial false-positive rate was unchanged. Median serum levels of uE3 were significantly higher in the 33 women whose onset of diabetes was prior to 19 years of age (0·99 MOM) than in the 19 women whose onset of diabetes was at age 19 or older (0·84 MOM). This is the first population-based study to investigate the relationship between diabetes and serum levels of AFP, uE3, and hCG, and confirms earlier observations from a case—control study that found only slightly lower uE3 and hCG levels.  相似文献   
494.
Nine centres collaborated to examine the feasibility of a screening method for trisomy 18 that was based on assigning individual risk, using a combination of maternal age and measurements of alpha-fetoprotein (AFP), unconjugated oestriol (uE3), and human chorionic gonadotropin (hCG). Second-trimester measurements of these analytes were obtained from 94 trisomy 18 pregnancies. In the 89 pregnancies without an associated open defect, the median levels for AFP, uE3, and hCG were 0.65, 0.43 and 0.36 multiples of the unaffected population median, respectively. The strongest individual predictor of risk for trisomy 18 was uE3, followed by hCG, AFP, and maternal age, in that order. Using a method of individual risk estimation that is based on the three markers and maternal age, 60 per cent of pregnancies associated with trisomy 18 would be detected at a risk cut-off level of 1:100, with a false-positive rate of about 0.2 per cent. One in nine pregnancies identified as being at increased risk for trisomy 18 would be expected to have an affected pregnancy. This risk-based screening method is more efficient than an existing method that is based on fixed analyte cut-off levels. Even though the birth prevalence of trisomy 18 is low, prenatal screening can be justified when performed in conjunction with Down syndrome screening and when a high proportion of women offered amniocentesis have an affected fetus.  相似文献   
495.
Ciba-Geigy is a specialty chemical and pharmaceutical company that is managing over 100 CERCLA and RCRA remediation sites in 38 states. The potential cost is over $500 million. The sites vary in their scope and technical complexity. For years management was frustrated by their lack of control over the selection of cleanup remedies and associated costs. This article shows how the company changed the method of managing remediation projects in an attempt to gain control over the process and improve overall environmental quality performance.  相似文献   
496.
ABSTRACT: A framework for combining economic factors and the hydrolo of detention basins is provided. The general development of economic production functions for water quality (sediment) and flood control is discussed. Example production functions are generated to compare water quality (sediment control only) and flood control. For the given example, the design of a detention basin for downstream sediment control is economically unwarranted. When compared to on-site detention facilities, regional detention structures appear to be more practical from an economic standpoint for water quality control. Since sediment was the only water quality parameter assessed, it is entirely possible that the design of a detention basin for water quality control would be justified if the effects of all pollutants of concern could be quantified. Policy aspects of detention facilities that relate to the economics of water quality control are also discussed.  相似文献   
497.
Suburban forest fragments often experience heavy recreational and waste disposal use, with considerable damage to the vegetation. To suggest strategies for conservation of the forest flora, spatial distributions of human impact were described in 40 fragmentary stands in northern New Castle County, Delaware. The distribution of human impact showed a significant bias to the forest edge, with 95% of localized damage occurring in the first 82 m. Forms of impact related to lawn maintenance fell significantly closer to the edge than impacts related to recreation and showed the strongest edge orientation. Edge distances of campsites, vandalized trees, and firewood gathering were negatively correlated with distance to the nearest graded road, indicating the importance of road access. Several forms of impact were also clustered near footpaths, although distance to paths was independent of edge distance in all cases. In terms of penetration of the forest and severity of damage, human impact greatly exceeds natural edge effects reported for this community. These findings suggest that damage may be minimized by limiting road access and avoiding the creation of small forest fragments.  相似文献   
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Thermoplastic urethanes based on polyricinoleic acid soft segments and MDI/BD hard segments with varied soft segment concentration were prepared. Soft segment concentration was varied from, 40 to 70 wt%. Biodegradation was studied by respirometry. Segmented polyurethanes with soft segments based on polyricinoleic acid degrade relatively slow losing about 11% carbon after 30 days, but faster than corresponding petrochemical polyesterurethanes. Since biodegradation proceeds mainly through the soft segments, higher soft segment content polymers displayed slightly higher biodegradation. Polyurethanes with dispersed hard domains in the soft phase displayed slightly faster biodegradation than those with co-continuous morphology. Polyester diol degrades slower than castor oil but significantly faster than the polyurethanes with built in soft segments from the same diol. Castor oil biodegrades slower than soybean oil.  相似文献   
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