Serological screening for cytomegalovirus during pregnancy: A systematic review of clinical practice guidelines and consensus statements

Background

Congenital cytomegalovirus (cCMV) is the most common congenital infection worldwide. cCMV can lead to severe long-term sequelae, including neurological impairment and developmental delay. We performed a systematic review of clinical practice guidelines containing recommendations concerning serological screening for CMV during pregnancy.

Method

We performed a search of MEDLINE, Turning Research into Practice (TRIP) database and the grey literature for clinical practice guidelines or consensus statements published in the English language from Jan 2010 to June 2022. The quality of the included guidelines was assessed using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. Textual synthesis was used to summarise and compare the recommendations on CMV serological screening in pregnancy.

Results

Eleven guidelines and two consensus statements were included. None recommended universal serological screening for CMV in pregnant women; five recommended screening for high-risk women (those with frequent contact with young children). The overall quality of the guidelines varied; most were medium or low.

Conclusions

Although clinical practice guidelines do not actively recommend routine serological screening in pregnancy, most did not meet standard processes for development and predated the emerging data on valaciclovir as a potential intervention. Existing recommendations are underpinned by limited, low-level evidence, exposing the lack of robust data in this area of practice. Further high-level evidence and methodologically robust guidelines are needed to guide clinical practice in this rapidly changing field.     

Polyethylene microplastic toxicity to the terrestrial snail Cantareus aspersus: size matters

Environmental Science and Pollution Research - Plastic has become the most widespread human-made material and small fragments (< 5mm, so called microplastics, MPs) accumulate in all the...     

Cyclodextrin applications in pharmacy,biology, medicine,and environment

Environmental Science and Pollution Research -     

Evaluation of uptake of the cytostatic methotrexate in Elliptio complanata mussels by LC–MS/MS

Environmental Science and Pollution Research - Aquatic organisms are continuously exposed to emerging contaminants coming from urban effluents of wastewater treatment plants. The contamination of...     

Eocene bunoselenodont Artiodactyla from southern Thailand and the early evolution of Ruminantia in South Asia

Although Asia is thought to have played a critical role in the basal radiation of Ruminantia, the fossil record of early selenodont artiodactyls remains poorly documented in this region. Dental remains of a new bunoselenodont artiodactyl are described from the late Eocene of Krabi, southern Thailand. This new form, Krabitherium waileki gen. et sp. nov, is tentatively referred to the Tragulidae (Ruminantia) on the basis of several dental features, including a weak Tragulus fold and the presence of a deep groove on the anterior face of the entoconid. Although this new form is suggestive of the enigmatic ?Gelocus gajensis Pilgrim 1912 from the “base of the Gaj” (lower Chitarwata Formation) of the Bugti Hills (Central Pakistan), K. waileki most likely represents an early representative of a relatively bunodont group of tragulids that includes the genus Dorcabune, known from the Miocene of south Asia. This addition to the Eocene record of early ruminants attests to the antiquity of the group in Southeast Asia and lends support to the hypothesis that the Tragulidae represents one of the first offshoots in the evolutionary history of Ruminantia.     

Changing the Course of Rivers in an Asian City: Linking Landscapes to Human Benefits through Iterative Modeling and Design

Concerns over water scarcity, climate change, and environmental health risks have prompted some Asian cities to invest in river rehabilitation, but deciding on the end goals of rehabilitation is a complex undertaking. We propose a multidisciplinary framework linking riparian landscape change to human well‐being, providing information relevant to decision makers, in a format that facilitates stakeholder involvement. We illustrate this through a case study of the densely settled, environmentally degraded, and flood prone Ciliwung River flowing through metropolitan Jakarta, Indonesia. Our methodology attempts to respond to this complexity through an iterative approach, strongly based on conceptualization and mathematical modeling. Nested hydrologic, hydrodynamic, and water quality models provide outputs at catchment‐, corridor‐, and localized site‐scales. Advanced 3‐D landscape modeling is used for procedural design and precise visualization of proposed changes and their impacts, as predicted by the mathematical models. Finally, participatory planning and design methods allow us to obtain critical stakeholder feedback in shaping a socially acceptable approach. Our framework aims at demonstrating that a change in paradigm in river rehabilitation is possible, and providing future scenarios that balance concerns over flooding, water quality, and ecology, with the realities of a rapidly growing megacity.