The impact of non-invasive prenatal testing on anxiety in women considered at high or low risk for aneuploidy after combined first trimester screening

Objective: The aim of this study was to (1) examine the psychological impact of non-invasive prenatal testing (NIPT) in women with a high-risk (≥1 : 300) and low-risk (≤1 : 301) result on combined first trimester screening (cFTS) and (2) to examine factors influencing anxiety and decision-making in both risk populations. Method: Questionnaires and structured interviews were administered to low (n = 50) and high (n = 63) risk women at the time of NIPT blood draw (point A) and again at least 1 week after receiving their NIPT result (point B). Anxiety levels were measured at these two time points using the State–Trait Anxiety Inventory. Results: Both high-risk and low-risk cFTS groups demonstrated similar intrinsic (trait) anxiety levels (36 ± 10 vs 35 ± 10; p = 0.70). High-risk women had significantly higher levels of state anxiety at point A than low-risk women (42 ± 11 vs 36 ± 11; p < 0.01). Both groups had a statistically significant reduction (p < 0.01), to similar final levels of state anxiety at point B (30 ± 11 vs 29 ± 8; p = 0.61). Conclusion: Women receiving a high-risk result on cFTS have higher levels of state anxiety than their low-risk counterparts. Following a low-risk NIPT result, the anxiety levels in both populations are reduced to similar levels. © 2017 John Wiley & Sons, Ltd.     

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.

     

Children's reasoning about poverty, physical deterioration, danger, and retribution in neighborhood contexts

This study examined children's moral, social and personal reasoning patterns about different neighborhood contexts. Three hundred and seventy-seven participants were selected from grades 2, 4, 6, and 8. Participants were shown 2 sets of photographs depicting the exact same houses and neighborhoods. One photograph displayed higher levels of physical incivilities and the other displayed higher levels of territoriality and place attachments. The vast majority of participants made strong social attributions of both danger and poverty towards physical contexts, depending on the level of incivilities depicted in the photographs. Moreover, an overwhelming majority gave justifications that fell into the moral domain. For most of the participants, the immorality of retribution overrode the negative attributions surrounding context. However, for those that approved of retribution behaviors, the physical setting appeared to influence their judgments. The findings suggest that the concept of extreme poverty (as represented by physical incivilities) and danger are fused at the cognitive level through linked interpretations of the same environmental cues.     

Composting of miscible cellulose acetate propionate-aliphatic polyester blends

A series of miscible blends consisting of cellulose acetate propionate (CAP) and poly(ethylene glutarate) (PEG) or poly(tetramethylene glutarate) (PTG) were evaluated in a static bench-scale simulated municipal compost environment. Samples were removed from the compost at different intervals, and the weight loss was determined before evaluation by gel permeation chromatography, scanning electron microscopy, and¹H NMR. The type of polyester (PEG versus PTG) in the blend made no difference in composting rates. At fixed CAP degree of substitution (DS), when the content of polyester in the blend was increased, the rate of composting and the weight loss due to composting increased. When the CAP was highly substituted, little degradation was observed within 30 days and almost all of the weight loss was ascribed to loss of polyester. Although the polyester was still observed to degrade faster, when the CAP DS was below approximately 2.0, both components are observed to degrade. The data suggests that initial degradation of the polyester is by chemical hydrolysis and the rate of this hydrolysis is very dependent upon the temperature profile of the compost and upon the DS of the CAP.     

Intensity of territorial defense in red squirrels: an experimental test of the asymmetric war of attrition

Summary Red squirrels defend exclusive, individual territories year round, 20% to 50% of females do not breed in any given year, and breeding females raise juveniles on their territories. Breeding is asynchronous, and the offspring of early-breeding females are more likely to hold an independently won territory than are late-born offspring. Based on the asymmetric war of attrition, we made the following predictions: (1) squirrels would respond more intensely to the calls of unfamiliar individuals than to the calls of neighbors; (2) breeding females would respond more intensely to unknown calls than would non-breeding females or males; (3) early-breeding females would respond more intensely than would late-breeding females to unknown calls; and (4) all classes of squirrels would respond similarly to the calls of neighbors. Playback experiments supported the predictions. Alternative hypotheses of kin selection, risk of infanticide, and seasonal difference in intruder pressure could not explain the results.     

Epidemiology of alcohol and other drug use among motor vehicle crash victims admitted to a trauma center

The objectives of this research were to (1) determine the incidence and prevalence of alcohol and other drug use among motor vehicle crash (MVC) victims admitted to a regional Level-I trauma center, and (2) to examine the utility of using a rapid point-of-collection (POC) drug-testing device to identify MVC patients with drug involvement. Blood and urine specimens were routinely collected per clinical protocol for each MVC victim at the time of admission. Blood alcohol concentration (BAC) levels were determined per standard clinical protocol. Clinical urine specimens were routinely split so that a POC drug-testing device for the detection of commonly abused drugs (Marijuana, Cocaine, Amphetamines, Methamphetamines, and Opiates) could be compared to that of the standard hospital laboratory analysis of each urine specimen (which also included Barbiturates and Benzodiazepines). In the six-month period of this study, nearly two-thirds of trauma center admissions were victims of motor vehicle crashes. During this time, blood and urine was collected from 322 MVC victims. Toxicology results indicated that 59.3% of MVC victims tested positive for either commonly abused drugs or alcohol. More patients tested positive for drug use than tested positive for alcohol, with 33.5% testing positive for drug use only, 15.8% testing positive for alcohol use only, and 9.9% testing positive for both drugs and alcohol. Less than half (45.2%) of the substance-abusing patients in this study would have been identified by an alcohol test alone. After alcohol, marijuana and benzodiazepines were the most frequently detected drugs. Point of collection (POC) test results correlated well with laboratory results and provide important information to initiate rapid intervention/treatment for substance use problems among injured patients.