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61.
An omphalocele is a congenital defect in the abdominal wall characterized by absent abdominal muscles, fascia, and skin. The characteristic ultrasound appearance includes a midline defect with herniation of abdominal contents into the base of the umbilical cord. Other anatomic abnormalities are seen in approximately 50% of cases, most notably cardiac defects (19%–32%). Approximately, 50% of cases are associated with genetic and multiple malformation syndromes including trisomy 13/18, pentalogy of Cantrell and Beckwith–Wiedemann syndrome. Therefore, a thorough evaluation is recommended, including detailed anatomic survey, fetal echocardiogram, genetic counseling, and prenatal diagnostic testing. Overall prognosis depends on the size of the omphalocele, genetic studies, and associated anomalies. Early prenatal diagnosis remains important in order to provide parental counseling and assist in pregnancy management. Delivery should occur at a tertiary care center. Timing and mode of delivery should be based on standard obstetric indications with cesarean delivery reserved for large omphalocele (>5 cm) or those that involve the fetal liver. Neonatal management involves either primary or staged reduction, both of which can be associated with a prolonged neonatal hospitalization. 相似文献
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63.
旅游认证体系 总被引:1,自引:0,他引:1
Martha Honey 《生态毒理学报》2002,24(3):28-29
研究者们在全世界范围内确定了约 250种自愿性举措用来设立旅游业标准 . 这些举措包括行动 规范、奖励、标准检测、最佳方法和大约 70种提供批准标识或标志的生态标签和认证体系 . 这些体系越来越多地被用来展示在社会和 /或环境方面较好的行业 . 相似文献
64.
Diabetes is an increasingly common diagnosis among pregnant women. Pregestational diabetes is associated with an increase in many adverse pregnancy outcomes, which impact both on the woman and her fetus. The models of pregnancy care for women with diabetes are based largely on observational data or consensus opinion. Strategies for aneuploidy screening and monitoring for fetal well-being should be modified in women with diabetes. There is an increasing understanding of the mechanisms by which congenital anomalies and disorders of fetal growth occur, involving epigenetic modifications, changes in gene expression in critical developmental pathways, and oxidative stress. This knowledge may lead to pathways for improved care for these high-risk pregnancies. 相似文献
65.
/ The Council on Environmental Quality's (CEQ's) principal aims in implementing the National Environmental Policy Act (NEPA) are (1) to reduce paperwork, (2) to avoid delay, and most importantly (3) to produce better decisions that protect, restore, and enhance the environment. This paper presents four strategies for improving the NEPA process along with tools that can be used to implement each strategy. The tools include guidelines for project management and problem definition, tips for acquiring existing information and identifying issues of public concern, worksheets on how to identify and analyze potential impacts on resources, ideas for enhancing NEPA documents, and a NEPA process checklist. The tools can be used at various stages of the NEPA process and provide a toolbox of guidelines and techniques to improve implementation of the NEPA process by focusing the pertinent information for decisionmakers and stakeholders. KEY WORDS: National Environmental Policy Act; NEPA; Environmental impact assessment; Ecosystem management 相似文献
66.
Martha W. Gilliland Gerald P. Wallin Ronald Smaus 《Journal of the American Water Resources Association》1989,25(1):49-61
ABSTRACT: Nebraska has abundant supplies of high quality surface and ground water. The U.S. Supreme Court decision in 1982, declaring ground water to be an article of commerce, is widely perceived as giving neighboring states easier access to Nebraska water. Some neighboring states, particularly Colorado and Wyoming, are in water short situations. Additionally, current legal restrictions on certain types of transfers within the State could be inhibiting the “highest and best use” of Nebraska's water. Thus, in 1987 the Nebraska Legislature called for the development of a new water policy for Nebraska that would promote the economically efficient use of water, yet protect the environment as well as the rights of individuals (for example, third parties) and the public. Through an interagency study employing an extensive public involvement process, a policy to be recommended to the Legislature in 1989 emerged. The policy revises the basic definition of water rights and transfers and eliminates most of the inconsistencies in the water allocation system by treating most types of water resources, most types of water users, and most locations of use similarly in the permitting process. (The principal exception is the individual irrigator using ground water on the overlying land where overlying land is one government surveyed section; such use is not defined to be a transfer nor is a permit required.) An impact assessment would be required of most new water uses except on site uses of ground water. Compensation measures could be specified as a condition of the permit where appropriate. The permit would be issued only if the benefits of the proposed transfer clearly outweigh adverse effects that could not be avoided or effectively compensated. The policy allows for the sale or lease of “salvaged” water. It calls for the State to facilitate transfers by acting as a clearinghouse for potential buyers and sellers, and it allows the State to sponsor water projects. An annual fee to be paid by many water users, in order to provide a fund for compensation and for state sponsored water projects, was proposed. However, it met with extensive opposition. Thus, the policy recommends only that the Legislature examine potential funding programs and equitable user fees. 相似文献
67.
Martha W. Gilliland Wanada Baxter-Potter 《Journal of the American Water Resources Association》1987,23(2):281-291
ABSTRACT: Bacterial densities (total coliform, fecal coliform, and fecal streptococci) and suspended solids in runoff from a feedlot, pasture, and corn field were measured. Densities of fecal coliform were highest from the feedlot but were 1000 to 10,000 times greater than the water quality standard for swimmable waters from all three land uses. Densities of fecal streptococci were highest from the corn field, which suggests that wildlife are the source of bacteria. Fecal coliform/fecal streptococci ratios distinguished cattle from wildlife as the source of bacterial pollution both among land uses and among seasons of the year. Suspended solids concentrations in runoff ranged from 423 to 925 mg/l and were highest from the corn field. A Geographic Information System (GIS), which utilizes a raster or grid-cell format, was developed to include algorithms associated with non-point source pollution. The system accepts digitally mapped information on soil type, topography, and land use. It calculates characteristics such as slope and slope length, and relates these characteristics to soils and land use parameters in order to produce three dimensional maps of runoff potential, sediment pollution potential, and bacterial pollution potential. It offers the advantages of retaining the geographic character of pollution potential information and of conveying in three-dimensional graphical terms the effects of topography, soil type, land use, and land management practices. 相似文献
68.
Istre GR McCoy M Stowe M Barnard JJ Moore BJ Anderson RJ 《Traffic injury prevention》2007,8(4):398-402
OBJECTIVE: To explore the epidemiology of pedestrian deaths in Dallas County, Texas, and to compare factors associated with pedestrian deaths on expressways versus those that occurred on other roadways. METHODS: We studied all pedestrian deaths among persons 15 years of age or older in Dallas County, Texas, from 1997 to 2004 by linking data from Medical Examiner's office, the Fatality Analysis Reporting System, and local police records. Univariate and multivariate analysis compared various factors associated with death on an expressway. RESULTS: Among 437 pedestrian deaths who were 15 years of age or older, 197 (45%) occurred on expressways; the proportion that occurred on expressways was highest among 15- to 29-year-olds (65%) and was lower with advancing age group (p < 0.01, chi square for trend). At least 36% of these expressway-related pedestrian deaths were known to have been "unintended pedestrians," who had exited a vehicle after being on the roadway, compared with 11% of pedestrian deaths on surface streets (OR 4.6, 95% CI, 2.7-8.1), and this was also highest among younger age groups. Pedestrian deaths on an expressway, compared with deaths on surface streets, remained strongly associated with having been an "unintended pedestrian" (OR 6.2, 95% CI, 3.1-14.0), after controlling for several other variables, including age, sex, race, nighttime of crash, and alcohol involvement. CONCLUSIONS: Expressways are the predominant site of fatal pedestrian crashes among young adults in this urban area. Since many of these deaths were "unintended pedestrians," procedures for management of occupants of disabled vehicles on expressways could have a large impact on pedestrian deaths in young adults. 相似文献
69.
Ulloa-Ogaz Ana Laura Piñón-Castillo Hilda Amelia Muñoz-Castellanos Laila Nayzzel Athie-García Martha Samira Ballinas-Casarrubias María De Lourdes Murillo-Ramirez José Guadalupe Flores-Ongay Luis Ángel Duran Robert Orrantia-Borunda Erasmo 《Environmental science and pollution research international》2017,24(27):22048-22060
Environmental Science and Pollution Research - The cytotoxicity of nanoparticles (NPs) and their properties are important issues in nanotechnology research. Particularly, NPs affect the metabolism... 相似文献
70.
Borras-Guevara Martha Lucia Batres Carlota Perrett David I. 《Behavioral ecology and sociobiology》2017,71(12):1-11
Behavioral Ecology and Sociobiology - Honey bee colonies require adequate pollen for maintenance and growth. Pollens vary in nutritional value, and a balanced diet is achieved by mixing pollens... 相似文献