Maternity health care professionals' views and experiences of fetal genomic uncertainty: A review

The field of prenatal screening and diagnosis for fetal anomalies has been marked by a rapid succession of technological advances, including most notably, chromosomal microarray analysis, and next generation sequencing. Despite the diagnostic advantages of these technologies, their incorporation into prenatal testing has created additional challenges of revealing genomic variants of unknown or uncertain significance, and secondary findings. While detailed posttest counseling about uncertain variants is best performed by medical geneticists, many of the screening and diagnostic tests that lead to this information are actually ordered by general maternity health care professionals (HCPs), such as obstetricians, midwives, and family physicians. Maternity HCPs support pregnant women through to the conclusion of their pregnancy and the postpartum period, and thus are close observers of the psychosocial impart of fetal genomic uncertainty on women and their families. While there have been many studies exploring the handling of genomic uncertainty by genetics HCPs, there has been relatively less attention paid to maternity HCPs without speciality training in genetics. This review explores the current literature surrounding nongenetic maternity HCPs' views and experiences of genomic uncertainty and returning uncertain results in the prenatal setting.     

Triad case study: Rattlesnake Creek

The U.S. Army Corps of Engineers (US ACE) is responsible for conducting the cleanup of radiological contaminated properties as part of the Formerly Utilized Sites Remedial Action Program. One property is the Rattlesnake Creek (RSC) portion of the Ashland sites. The RSC stream sediments are contaminated with thorium‐230, radium‐226, and uranium. The US ACE is closing RSC using protocols contained within the Multi‐Agency Radiation Survey and Site Investigation Manual (MARSSIM). At RSC, the US ACE developed site‐specific derived concentration guideline level (DCGL) cleanup requirements consistent with the MARSSIM guidance. Because of uncertainty about the distribution of contamination within the creek, the US ACE used the Triad approach to collect data and design remedial actions. Systematic planning helped target the areas of concern, develop a conceptual site model, and identify data gaps to be addressed before remediation plans were finalized. Preremediation sampling and analysis plans were designed to be explicitly consistent with final status survey requirements, allowing data sets to support both excavation planning needs and closure requirements in areas where contamination was not encountered above DCGL standards. Judicious use of real‐ time technologies such as X‐ray fluorescence and gamma walkover surveys minimized expensive off‐ site alpha spectrometry analyses, and at the same time provided the ability to respond to unexpected field conditions. © 2004 Wiley Periodicals, Inc.     

Statewide Survey of Hormones and Antibiotics in Surface Waters of Delaware

Water‐quality surveys have confirmed the presence of hormones and antibiotics in surface waters of the United States, which may be of concern to aquatic life. We investigated the concentrations of hormones and antibiotics in surface waters of the state of Delaware to determine – how they compared against environmental thresholds, how they varied across the state, and if they were correlated with land use type. Fifty surface water locations were sampled during early spring and late summer. Water samples were initially screened with ELISA followed by analysis with LC/MS/MS. The measured ranges of hormone concentrations were: 0‐3.71 ng/l for estrone, 0‐4.65 ng/l for estrone‐3‐sulfate, and 0‐6.27 ng/l for 17β‐estradiol. The measured ranges of antibiotics were: 0‐3.30 ng/l for sulfamerazine, 0‐10.74 ng/l for sulfamethoxazole, and 0‐2.29 ng/l for tetracycline. The predicted no‐effect concentration (PNEC) for estrone was exceeded for three samples and the PNEC for 17β‐estradiol was exceeded for 11 samples. In general, concentrations and detection frequencies were lower in the summer than the spring. The highest concentrations of hormones and antibiotics were spatially distributed in agricultural and urban areas; however, the correlations between land use type and the concentrations were weak. This study was the first statewide survey of hormones and antibiotics for Delaware and provided important baseline data on these emerging contaminants.     

Selection of a suitable mobile phase for the speciation of four arsenic compounds in drinking water samples using ion-exchange chromatography coupled to inductively coupled plasma mass spectrometry

The performance of two mobile phase buffers, phosphate and TRIS, were compared for the speciation of four arsenic species: arsenate (As(V)), arsenite (As(III)), mono methylarsonic acid (MMA), and dimethyl arsinic acid (DMA) in drinking water, using ion-exchange chromatography inductivelycoupled plasma mass spectrometry (IEC-ICP-MS). The mobile phase containing TRIS acetate buffer ("TRIS") demonstrated superior perfomance in baseline separation of all four arsenic species and the internal standard. It is also applicable to high-throughput sample analysis as it minimized the frequency required to clean the sampling interface due to salt build-up when compared to the phosphate mobile phase. The method was evaluated for its precision, accuracy, linearity and detection limits. The method was successfully applied for the analysis of drinking water samples.     

Development of Indicators to Assess Economic Vulnerabilities to Changes in Ecosystem Services: Case Study of Counties in Maryland,USA

We develop indicators showing the relative environmental burdens that human activities place on locales for a given level of economic benefits. The main purpose is to develop tools that allow us to examine the potential vulnerabilities within economies to changes in resource conditions. The indicators of pollution emission or resource consumption per job can be used to identify potential challenges to resource and industry managers and to compare areas in terms of their ability to adapt to change. For example, if a large number of area jobs are dependent on abundant water, this indicates a vulnerability to a reduction in water availability for industrial use. We develop a case study for 23 counties and 1 city in Maryland to examine the usefulness and limitations of the indicators. Our case study demonstrates that the indicators provide an informative view into patterns of local economic activity and use of an area’s environmental goods and services. In contrast to patterns for total environmental burdens (e.g., total SO₂ emissions) that are typically reported, the rates of environmental burden per job are not simply correlated with high or low economic output. Thus, the indicators represent distinct patterns of environmental burdens per job that reflect reliance on environmental services. The indicators have some limitations when used at this fine scale because they can misrepresent conditions in counties in which economic sectors are dominated by one or a few businesses. For this reason, the indicators are best used as a regional screening tool.