Transverse limb reduction defects after chorion villus sampling: A retrospective Cohort study

A retrospective cohort study was performed in five Italian obstetrical centres from 1984 to 1991 in order to verify the association between chorionic villus sampling (CVS) and transverse limb reduction defects (TLRDs). TLRD rates by period of gestation at CVS were calculated, and the study's results were compared with data from the general population. Of the 3430 pregnancies for which CVS was performed, 2759 had a known outcome. The overall rate for TLRDs was 1 in 1143 CVS pregnancies, four times higher than that of the general population in Italy (1 in 4458). The rate of TLRDs was 2·9/1000 for CVS performed at 9 weeks' gestation and 1·0/1000 for CVS at 10 weeks' gestation. A scalp defect was detected in a pregnancy in which CVS was performed at 10 weeks. A high proportion of pregnancies lost to follow-up and the poor quality of the data may have affected the results. Nevertheless, our results suggest an association between CVS carried out at less than 10 weeks' gestation and TLRDs which is consistent with the findings of other studies. CVS should not be prepared at less than 10 weeks' gestation until additional evidence is obtained.     

Prenatal diagnosis and management of fetal ovarian cysts

Congenital ovarian cysts are a pathological condition which can be diagnosed in utero by ultrasound. We report 14 consecutive diagnoses of fetal ovarian cysts, obtained in the second and third trimesters of pregnancy. Congenital ovarian cysts have almost invariably a good prognosis, and no change in the standard obstetrical management is required. However, the evolution of the disease in utero is extremely variable. The cyst may increase in size, decrease or even disappear, or undergo complications such as torsion and rupture, which may carry some risks to the fetus. When a fetal ovarian cyst is detected, serial ultrasound examinations should be performed. If one of the above complications is suspected, the option of prompt caesarean section should be considered.     

Road traffic injury in sub-Saharan African countries: A systematic review and summary of observational studies

Objective: The aim of this study is to evaluate, through a systematic review of hospital-based studies, the proportion of road traffic injuries and fatalities in sub-Saharan Africa (SSA).

Methods: In accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Meta-analysis of Observational Studies in Epidemiology guidelines, we searched the following electronic databases: PubMed, Embase, Africa-Wide Information, Global Health, and Web of Science. Articles were eligible if they measured proportion of road traffic injuries (RTIs) in SSA by using hospital-based studies. In addition, a reference and citation analysis was conducted as well as a data quality assessment.

Results: Up to 2015, there were a total of 83 hospital-based epidemiologic studies, including 310,660 trauma patients and 99,751 RTI cases, in 13 SSA countries. The median proportion of RTIs among trauma patients was 32% (4 to 91%), of which the median proportion of death for the included articles was 5% (0.3 to 41%).

Conclusion: The number of studies evaluating RTI proportions and fatalities in SSA countries is increasing but without the exponential rise expected from World Health Organization calls for research during the Decade of Action for Road Traffic Injuries. Further research infrastructure including standardization of taxonomy, definitions, and data reporting measures, as well as funding, would allow for improved cross-country comparisons.     

Environmental impact assessment of a WtE plant after structural upgrade measures

The study focuses on analysing the evolution of environmental impacts caused by a medium–large Italian WtE plant before and after revamping and maintenance operations, with the aim of providing an evaluation of how much these structural upgrade measures may affect the total environmental performance.LCA methodology was applied for the modelling and comparison of six WtE scenarios, each describing the main structural upgrades carried out in the plant over the years 1996–2011. The comparison was conducted by adopting 1 ton of MSW as the functional unit, and the net contribution from energy recovery to power generation was distinguished by defining consistent national grid electricity mixes for every year considered. The Ecoindicator99 2.09 impact assessment method was used to evaluate the contribution to midpoint and endpoint categories (e.g. carcinogens, respiratory inorganics and organics, climate change, damage to human health). Lastly, the “Pedigree quality matrix” was applied to verify the reliability and robustness of the model created.As expected, the results showed better environmental scores after both the implementation of new procedures and the integration of operations. However, while a net reduction of air emissions seems to be achievable through dedicated flue gas treatment technologies, outcomes underscored potentials for improving the management of bottom ash through the adoption of alternative options aimed to use that solid residue mainly as filler, and to decrease risks from its current disposal in landfill. If the same effort that is put into flue gas treatment were devoted to energy recovery, the targets for the WtE plant could be easily met, achieving a higher sustainability. This aspect is even more complex: national policies for implementing greener and renewable energy sources would result in a lower impact of the national energy mix and, hence, in a lower net avoided burden from energy recovery.The study confirmed the expected improvements, indicating quantitatively the lower environmental impact resulting from structural upgrade operations in a WtE plant. Furthermore, the work highlights the importance of considering the evolution of the national energy mix in LCA studies, especially during the present years of transition from fossil fuels to renewable sources.     

Giving parks back to people: a transportation study of New Orleans City Park with implications for improving public health

Park planning, once at the root of the profession during the nineteenth century, can again provide cities with a means to improve public health through restricting access to automobiles. This intercept study, conducted in New Orleans City Park, found that two-thirds of users support weekend street closures to automobiles. Widespread support (63%) exists even among the 72% of people who arrived by automobile. This study also found measurable stated benefits from restricting car access. For more than 53% of the sample that stated that they would walk more in a car-free zone, respondents noted that they would walk nearly 30?min more per month. These findings suggest that planners and policy-makers have a cost-effective option to improve cities and public health – taming the automobile in urban parks.     

Microcontroller PIC 16F877A standard based on solar cooker using PV—evacuated tubes with an extension of heat integrated energy system

Environmental Science and Pollution Research - The unavailability of sunlight during nighttime and cloudy weather condition has limited the usage of solar cookers throughout the day. This study...