Cell-free DNA screening in twin pregnancies: A more accurate and reliable screening tool

Objective

Outcome data from cell-free DNA (cfDNA) screening in twin gestations are limited. This study adds an appreciable number of confirmed outcomes to the literature, and assesses performance of cfDNA screening in twins over a 4.5-year period at one large clinical laboratory.

Method

Prenatal cytogenetic and SNP microarray results were cross-referenced with cfDNA results for twin pregnancies, yielding 422 matched cases. Using diagnostic results as truth, performance of cfDNA screening in this population was assessed.

Results

Of the 422 twin pregnancies with both cfDNA and diagnostic results, 3 specimens failed amniocyte analysis, and 48 samples (11.5%) were nonreportable from the initial cfDNA draw. Analysis of the 371 reportable samples demonstrated a collective sensitivity of 98.7% and specificity of 93.2% for trisomies 21/18/13. Positive predictive values (PPVs) in this study population, which is enriched for aneuploidy, were 78.7%, 84.6%, and 66.7% for trisomy 21, 18, and 13, respectively.

Conclusion

CfDNA screening in a cohort of twin pregnancies with matched diagnostic results showed superior performance compared to traditional serum biochemical screening in twins. This study adds to a growing body of evidence suggesting that cfDNA is an accurate and reliable screening tool for the major trisomies in twin pregnancies.

     

Improved estimates of net primary productivity from modis satellite data at regional and local scales.

We compared estimates of net primary production (NPP) from the MODIS satellite with estimates from a forest ecosystem process model (PnET-CN) and forest inventory and analysis (FIA) data for forest types of the mid-Atlantic region of the United States. The regional means were similar for the three methods and for the dominant oak-hickory forests in the region. However, MODIS underestimated NPP for less-dominant northern hardwood forests and overestimated NPP for coniferous forests. Causes of inaccurate estimates of NPP by MODIS were (1) an aggregated classification and parameterization of diverse deciduous forests in different climatic environments into a single class that averages different radiation conversion efficiencies; and (2) lack of soil water constraints on NPP for forests or areas that occur on thin or sandy, coarse-grained soil. We developed the "available soil water index" for adjusting the MODIS NPP estimates, which significantly improved NPP estimates for coniferous forests. The MODIS NPP estimates have many advantages such as globally continuous monitoring and remarkable accuracy for large scales. However, at regional or local scales, our study indicates that it is necessary to adjust estimates to specific vegetation types and soil water conditions.     

Understanding the RCRA corrective action process

The Resource Conservation and Recovery Act (RCRA) was enacted in 1976. The Hazardous and Solid Waste Amendments (HSWA) of 1984 specify “corrective action” requirements for protecting human health and the environment from environmental contamination at active hazardous waste treatment, storage, and disposal facilities. RCRA and its corrective action requirements are designed to prevent the creation of new Superfund sites by regulating and remediating active facilities. The RCRA corrective action process has four basic components: the facility assessment, facility investigation, corrective measures study, and corrective measures implementation. This article presents an overview of the RCRA corrective action process and presents four case studies from three U.S. EPA regions.     

EFFECTS OF LAND USE AND TOPOGRAPHY ON SOME WATER QUALITY VARIABLES IN FORESTED EAST TEXAS1

ABSTRACT: Spatial variation of five water quality variables were analyzed using composite water samples collected periodically from eight small watersheds (11.4–71.6 km²) in forested East Texas during 1977 through 1980. Based on 31 observations during the four-year period the average yield of nitrate-nitrite nitrogen (NNN), total kjeldahl nitrogen (TKN), total phosphorus (PO4), chloride (CHL), and total suspended sediment (TSS) were 1.43, 21.96, 3.09, 50.11, and 90.39 ka/ha/yr, respectively. Compared to the water quality standards of the U.S. Environmental Protection Agency (1976) and the Texas Department of Water Resources (1976) for CHL, TSS, and NNN, none of the observations exceeded the limits for public water supplies. The study showed that forested watersheds normally yielded stream flow with better quality than that from agricultural watersheds. Watersheds of greater percent of pasture area, mean slope, stream segment frequency, and drainage density produced greater concentrations for these five chemical parameters in water samples. Meaningful equations were developed for estimating mean average yields for each chemical parameter for each watershed with R² ranging from 0.77 to 0.96 and standard error of estimates from 17 to 33 percent of the observed means.     

Leaching of pharmaceuticals and personal care products in turfgrass soils during recycled water irrigation

An important beneficial reuse of treated wastewater (recycled water) in arid and semiarid regions is landscape irrigation. However, the environmental fate, especially groundwater contamination potential, of trace contaminants such as pharmaceuticals and personal care products (PPCPs) is a significant concern that can hinder the acceptance and adoption of such reuses. In this study, we irrigated mature turfgrass plots with nonspiked tertiary treated wastewater for over 6 mo at 100 or 130% of the reference evapotranspiration rate (ETo) and collected leachate water at the 90-cm depth on a weekly basis. In the recycled water, all 14 target PPCPs were consistently found, and the mean levels of atenolol, gemfibrozil, meprobamate, carbamazepine, and sulfamethoxazole were above 100 ng L. However, only five compounds were detected in the leachate at trace levels. Trimethoprim and primidone were frequently found, whereas the detection of sulfamethoxazole, meprobamate and carbamazepine was less frequent (<50%). When detected, the overall mean concentration in the leachate was 10.2 ng L for trimethoprim, 7.1 ng L for primidone, and 2.9 to 12.4 ng L for carbamazepine, sulfamethoxazole, and meprobamate. The majority of the target PPCPs were completely removed. Given that the irrigation rates were higher than normal, this study clearly demonstrated the efficacy of turfgrass systems in attenuating PPCPs during recycled water irrigation. However, it is also apparent that some PPCPs are more susceptible to leaching than others, and these PPCPs thus merit further research attention.     

The influence of satellite populations of emerald ash borer on projected economic costs in U.S. communities, 2010-2020

The invasion spread of the emerald ash borer (Agrilus planipennis Fairmaire) (Coleoptera: Buprestidae) is characterized by the formation of satellite populations that expand and coalesce with the continuously invading population front. As of January 2010, satellite infestations have been detected in 13 states and two Canadian provinces. Understanding how newly established satellite populations may affect economic costs can help program managers to justify and design prevention and control strategies. We estimate the economic costs caused by EAB for the 10-yr period from 2010 to 2020 for scenarios of fewer EAB satellite populations than those found from 2005 to 2010 and slower expansion of satellite populations found in 2009. We measure the projected discounted cost of treatment, removal, and replacement of ash trees (Fraxinus spp.) growing in managed landscapes in U.S. communities. Estimated costs for the base scenario with the full complement of satellites in 2005-2010 and no program to mitigate spread is $12.5 billion. Fewer EAB satellites from 2005 to 2010 delay economic costs of $1.0 to 7.4 billion. Slower expansion of 2009 satellite populations delays economic costs of $0.1 to 0.7 billion. Satellite populations that are both distant from the core EAB infestation and close to large urban areas caused more economic costs in our simulations than did other satellites. Our estimates of delayed economic costs suggest that spending on activities that prevent establishment of new satellite EAB populations or slow expansion of existing populations can be cost-effective and that continued research on the cost and effectiveness of prevention and control activities is warranted.