Turner syndrome-omphalocele association: Incidence,karyotype, phenotype and fetal outcome

Objective

Omphalocele is known to be associated with genetic anomalies like trisomy 13, 18 and Beckwith–Wiedemann syndrome, but not with Turner syndrome (TS). Our aim was to assess the incidence of omphalocele in fetuses with TS, the phenotype of this association with other anomalies, their karyotype, and the fetal outcomes.

Method

Retrospective multicenter study of fetuses with confirmed diagnosis of TS. Data were extracted from a detailed questionnaire sent to specialists in prenatal ultrasound.

Results

680 fetuses with TS were included in this analysis. Incidence of small omphalocele in fetuses diagnosed ≥12 weeks was 3.1%. Including fetuses diagnosed before 12 weeks, it was 5.1%. 97.1% (34/35) of the affected fetuses had one or more associated anomalies including increased nuchal translucency (≥3 mm) and/or cystic hygroma (94.3%), hydrops/skin edema (71.1%), and cardiac anomalies (40%). The karyotype was 45,X in all fetuses. Fetal outcomes were poor with only 1 fetus born alive.

Conclusion

TS with 45,X karyotype but not with X chromosome variants is associated with small omphalocele. Most of these fetuses have associated anomalies and a poor prognosis. Our data suggest an association of TS with omphalocele, which is evident from the first trimester.     

New findings on the generation of waste and emissions, and a modified cleaner production assessment approach-illustrated by leather production

New findings on the causes of waste and emissions, which were obtained from analysing numerous material streams in various sectors of industry, are presented in this article. It describes the implications of these findings for the vision of clean production, for formulating environmental policy concerning cleaner production targets, for the opportunities to assess to what extent the cleaner production targets have been met, and for the cleaner production assessment. A modified cleaner production assessment approach is presented, and illustrated using leather production as an example. The consequent implications for the diffusion of cleaner production are discussed.     

Risks of sea level rise to disadvantaged communities in the United States

Climate change and sea level rise (SLR) pose risks to coastal communities around the world, but societal understanding of the distributional and equity implications of SLR impacts and adaptation actions remains limited. Here, we apply a new analytic tool to identify geographic areas in the contiguous United States that may be more likely to experience disproportionate impacts of SLR, and to determine if and where socially vulnerable populations would bear disproportionate costs of adaptation. We use the Social Vulnerability Index (SoVI) to identify socially vulnerable coastal communities, and combine this with output from a SLR coastal property model that evaluates threats of inundation and the economic efficiency of adaptation approaches to respond to those threats. Results show that under the mid-SLR scenario (66.9 cm by 2100), approximately 1,630,000 people are potentially affected by SLR. Of these, 332,000 (～20%) are among the most socially vulnerable. The analysis also finds that areas of higher social vulnerability are much more likely to be abandoned than protected in response to SLR. This finding is particularly true in the Gulf region of the United States, where over 99% of the most socially vulnerable people live in areas unlikely to be protected from inundation, in stark contrast to the least socially vulnerable group, where only 8% live in areas unlikely to be protected. Our results demonstrate the importance of considering the equity and environmental justice implications of SLR in climate change policy analysis and coastal adaptation planning.     

A multi-agent simulation model for spatial optimisation of manure allocation

The EU Nitrate Directive has spurred many countries to regulate manure production and manure application. Farmers have three allocation options: spreading manure on their own land, transporting manure to other farmers' land or processing manure. The manure problem can be seen as an allocation problem. To better understand this allocation problem, we have developed the spatial mathematical programming multi-agent simulation (MP-MAS) model. This model has been applied in Flanders, Belgium, a region with a high concentration of livestock. The model evaluates the cost efficiency of policy intervention in the manure market through obliged processing. We propose to further optimise the policy using a regionally differentiated manure pressure indicator, which is directly derived from the dual outcome of the mathematical programme. This indicator increases transparency in the manure and processing market, leading to better decision support about location and type of manure processing.     

Humanpharmakawirkstoffe in der Umwelt: Einträge, Vorkommen und der Versuch einer Bestandsaufnahme

Background

The presence of a large spectrum of pharmaceutical agents has been reported for aquatic environments (surface—and groundwater) and other aquatic media (influents and effluents of sewage treatment plants) in Germany and beyond, including their occurrence in drinking water. Considering the large number of pharmaceuticals produced for human use and released into the environment, various authors (Sattelberger 1999, Hanisch et al. 2004, Castiglioni et al. 2006, IWW 2006, Stockholm County Council 2006) tried to compile ‘priority lists’ focusing on those substances with environmental relevance. The following agents are included in all lists: ciprofloxacine, clarythromycine (antibiotics), carbamazepine (anti-epileptic agent), bezafibrate (lipid reducer), clofibric acid (lipid reducer metabolite), ethinylestradiol (sex hormone) and cylophosfamide (cytostatic agent). The agents erythromycine and sulfamethoxazole (antibiotics), ibuprofen, indometacine, propyphenazone (analgesics), atenolol (beta-blocker) and ifosfamide (cytostatic agent) can be found in three of four priority lists.

Results

Pharmaceuticals mainly enter the aquatic environment via effluent water, coming from wastewater treatment plants (including hospital and household sewerage), untreated discharges (e.g, secondary transfer of active agents into ground- and surface waters via sewage sludge application in agriculture and via landfill leachate) and leakages in the municipal sewer network.

Discussion

Potential activities towards a reduced release of pharmaceuticals into the environment should consider primarily the origin of the exposure to allow a separation of drug containing flows already at the source. Following the latter it would be possible to minimize the contamination of spring-, ground- and surface waters which serve as raw water resources for drinking water supply. However, considering the actual water pollution with pharmaceuticals and other substances, ‘end-of pipe’ techniques in the sewage and drinking water treatment are absolutely essential.

Conclusions

Sustainability criteria (e.g. protection of drinking water resources, habitats and biocoenoses, recycling and economizing use of resources) and economic aspects of modern sewage disposal concepts require a useful choice and combination of technical measures as components of centralized and decentralized sewage and drinking water treatment methods. It is though not realistic to cover and eliminate all pharmaceutical agents of environmental relevance equally effective even if a catalogue of potential technical treatment methods is elaborated thoroughly. Therefore, a concentration of efforts on selected drug agents, at least following initially some of the priority lists, is recommended.

Recommendations and Perspectives

The contamination of the water cycle with pharmaceuticals is nevertheless not exclusively to be solved via the application of technical methods. The BMBF (Federal Ministry for Education and Research) funded project start (Management Strategies for Pharmaceuticals in Drinking Water, www.start-project.de) therefore tries by implementation of a transdisciplinary approach to integrate technical-, behavioral-, and agent-orientated management strategies towards a more comprehensive and sustainable problem solution.     

High-Velocity Stretching of Renewable Polymer Blends

Journal of Polymers and the Environment - We evaluated the influence of blending various renewable polymer grades and amounts to allow for high stretchability during stretching at 800 mm/s...     

Rückstände ausgewählter Humanarzneimittel in Oberflächenwasserkörpern im Einzugsgebiet Halle (Saale)

A method for the determination of 16 selected pharmaceuticals in surface water using LC-MS/MS has been developed Methods from literature were adapted within the scope of this study. The limit of quantification of 13 out of 16 analytes is below 10 ng/l. The analysis of samples from the Saale river and lakes around Halle demonstrated that Carbamacepin (Median 207 ng/l) and Diclofenac (Median 196 ng/l) are detectable at various sampling stations along the river. The wastewater path was identified as the most relevant source for pharmaceutical residues entering the environment. Besides, the results reveal increased levels of several substances in some smaller anabranches and brooks.     

Appropriate water supply and sanitation technology for developing countries in tropical monsoon climates

Summary In the past, the water supply and sewage services for the urban regions of developing countries have been provided, in the main, only for the more affluent areas of these cities. This paper, dealing especially with those countries with tropical monsoon climates, advocates the construction of more comprehensive systems.Experience drawn from a wide range of projects and a review of the relevant literature provokes the authors to emphasise the need for suitable manuals of appropriate technology for use in these developing countries. These manuals should provide a full set of environmental guidelines for the design of water supply and sewage/sanitation systems for use in these countries.Dr Harvey F. Ludwig is Chairman and Greg Browder is Environmental Engineer for SEATEC International Consulting Engineers, Bangkok, Thailand.