Value of maternal serum unconjugated oestriol measurement in prenatal screening for Down's syndrome

We compared the medical and financial cost-effectiveness of prenatal serum screening for Down's syndrome using maternal age, serum alpha-fetoprotein and human chorionic gonadotrophin with and without the use of unconjugated oestriol. The use of unconjugated oestriol is medically more cost-effective than screening without it at all levels of detection. The actual performance depends on whether gestational age is estimated using ‘dates’ or an ultrasound scan. At a detection rate of 60 per cent, the proportion of unaffected fetal losses per case diagnosed at amniocentesis is about 22 per cent less if gestational age is estimated using dates (time since the first day of the last menstrual period) and about 47 per cent less if it is based on an ultrasound scan examination. At this detection rate, the inclusion of unconjugated oestriol increases costs by about £2k per case diagnosed (£36k instead of £34k) if gestational age is estimated using dates, but it is no more expensive if gestational age is measured from an ultrasound scan examination (indeed, it is more cost-effective at detection rates above 60 per cent). Since there is little change in the financial cost with the inclusion of unconjugated oestriol, for the improved medical performance of screening, it is worthwhile including it in the screening test.     

Habitat-induced morphological variation influences photosynthesis and drag on the marine macroalga <Emphasis Type="Italic">Pachydictyon coriaceum</Emphasis>

Photosynthesis, growth, distribution, and persistence of macroalgae are determined in part by the physical environment in which they live. Therefore, discerning how macroalgae interact with their physical environment is necessary to better understand their physiological performance. The purpose of this study was to examine what photosynthetic and hydrodynamic costs and benefits the morphology of Pachydictyon coriaceum (Phaeophyta) confers on the thallus in a given environment. Principal components analysis of morphometric measurements of Pachydictyon coriaceum from different flow habitats and depths separated thalli into three distinct morphs: shallow wave-exposed, shallow wave-protected, and deep. To test the hypothesis that thallus morphology affects net photosynthesis (NP), thalli of three morphotypes of P. coriaceum were incubated in an enclosed recirculating flume under three simulated light/water flow environments representing conditions from which the three morphotypes were collected. The wave-protected and deep morphs had significantly higher rates of photosynthesis than the wave-exposed morph for all three simulated environments. The dense, compact shape of the wave-exposed morph readily streamlines with flow and in doing so, potentially shades many of its internal blades likely accounting for its lower biomass-specific NP. Drag coefficients (C _d) were estimated for the three morphotypes over a range of flow velocities between 0.08 and 0.47 m s⁻¹. At lower water flow velocities (0.08–0.21 m s⁻¹), wave-exposed morphs had the lowest C _d among the three morphotypes. But drag coefficients of the three morphotypes converged with increasing flow velocities, and at velocities >0.31 m s⁻¹ there were no differences in C _d among the three morphotypes. The results of this study indicate that the environmentally-shaped morphs influence photosynthesis and, to a lesser degree, hydrodynamic forces acting on P. coriaceum.     

The reflection method of line intercept sampling to eliminate boundary bias

When a line transect overlaps the boundary of the sampled region, it can be reflected back on top of itself into the region, thereby making it possible to include elements near the edge twice from the same transect. A practical advantage of doing so is the reduction of field time and effort compared to the customary procedure of folding the transect back into another part of the region. An estimator is presented which accounts for this procedure in a way that preserves design-unbiased estimation.     

Risk-based prenatal screening for trisomy 18 using alpha-fetoprotein,unconjugated oestriol and human chorionic gonadotropin

Nine centres collaborated to examine the feasibility of a screening method for trisomy 18 that was based on assigning individual risk, using a combination of maternal age and measurements of alpha-fetoprotein (AFP), unconjugated oestriol (uE3), and human chorionic gonadotropin (hCG). Second-trimester measurements of these analytes were obtained from 94 trisomy 18 pregnancies. In the 89 pregnancies without an associated open defect, the median levels for AFP, uE3, and hCG were 0.65, 0.43 and 0.36 multiples of the unaffected population median, respectively. The strongest individual predictor of risk for trisomy 18 was uE3, followed by hCG, AFP, and maternal age, in that order. Using a method of individual risk estimation that is based on the three markers and maternal age, 60 per cent of pregnancies associated with trisomy 18 would be detected at a risk cut-off level of 1:100, with a false-positive rate of about 0.2 per cent. One in nine pregnancies identified as being at increased risk for trisomy 18 would be expected to have an affected pregnancy. This risk-based screening method is more efficient than an existing method that is based on fixed analyte cut-off levels. Even though the birth prevalence of trisomy 18 is low, prenatal screening can be justified when performed in conjunction with Down syndrome screening and when a high proportion of women offered amniocentesis have an affected fetus.     

Arsenic and heavy metal mobility in iron oxide-amended contaminated soils as evaluated by short- and long-term leaching tests

Several iron-bearing additives were evaluated for their effectiveness in the attenuation of arsenic (As) in various contaminated soils. These were selected for their known or potential ability to adsorb As anions, thus changing the speciation of As in a soil system. Three soils with different sources of As contamination were investigated (canal dredgings, coal fly ash deposits, and low-level alkali waste). The amendments used were goethite (alpha-FeOOH), iron grit, iron (II) and (III) sulphates (plus lime), and lime, applied to the soils at a rate of 1% w/w. A series of leachate extraction tests (UKEA, ASTM and modified Dutch column leaching test) were conducted on the equilibrated amended soils. These were used to firstly evaluate the potential of the amendments as immobilising agents, and secondly to compare the short- and long-term durability of their effects. Column tests demonstrated the efficiency of iron oxides over the longer time scale; these treatments significantly reduced concentrations of arsenic in leachates from all treated soils. Amended soils were also observed to contain higher levels of lead (Pb) and cadmium (Cd) in their leachates, signifying that certain Fe-oxides potentially increased heavy metal mobility in treated soils. The conclusions were that whilst Fe-oxides may be used as effective in situ amendments to attenuate As in soils, their effects on other trace elements, such as Pb and Cd, require careful consideration.     

Injury Outcome in Crashes with Guardrail End Terminals

Objective: The goal of this study is to evaluate the crash performance of guardrail end terminals in real-world crashes. Guardrail end terminals are installed at the ends of guardrail systems to prevent the rail from spearing through the car in an end-on collision. Recently, there has been a great deal of controversy as to the safety of certain widely used end terminal designs, partly because there is surprisingly little real-world crash data for end terminals. Most existing studies of end terminal crashes used data from prior to the mid-1990s. Since then, there have been large improvements to vehicle crashworthiness and seat belt usage rates, as well as new roadside safety hardware compliant with National Cooperative Highway Research Program (NCHRP) Report 350, “Recommended Procedures for the Safety Performance Evaluation of Highway Features.” Additionally, most existing studies of injury in end terminal crashes do not account for factors such as the occurrence of rollover. This analysis uses more recent crash data that represent post-1990s vehicle fleet changes and account for a number of factors that may affect driver injury outcome and rollover occurrence.

Methods: Passenger vehicle crashes coded as involving guardrail end terminals were identified in the set of police-reported crashes in Michigan in 2011 and 2012. End terminal performance was expected to be a function of end terminal system design. State crash databases generally do not identify specific end terminal systems. In this study, the coded crash location was used to obtain photographs of the crash site prior to the crash from Google Street View. These site photographs were manually inspected to identify the particular end terminal system involved in the crash. Multiple logistic regression was used to test for significant differences in the odds of driver injury and rollover between different terminal types while accounting for other factors.

Results: A total of 1,001 end terminal crashes from the 2011–2012 Michigan State crash data were manually inspected to identify the terminal that had been struck. Four hundred fifty-one crashes were found to be suitable for analysis. Serious to fatal driver injury occurred in 3.8% of end terminal crashes, moderate to fatal driver injury occurred in 11.8%, and 72.3% involved property damage only. No significant difference in moderate to fatal driver injury odds was observed between NCHRP 350 compliant end terminals and noncompliant terminals. Car drivers showed odds of moderate to fatal injury 3.6 times greater than LTV drivers in end terminal crashes. Rollover occurrence was not significantly associated with end terminal type.

Conclusions: Car drivers have greater potential for injury in end terminal crashes than light truck/van/sport utility vehicle drivers. End terminal designs compliant with NCHRP 350 did not appear to carry different odds of moderate driver injury than noncompliant end terminals. The findings account for driver seat belt use, rollover occurrence, terminal orientation (leading/trailing), control loss, and the number of impact events. Rollover and nonuse of seat belts carried much larger increases in injury potential than end terminal type. Rollover did not appear to be associated with NCHRP 350 compliance.     

Trust in Sources of Soil and Water Quality Information: Implications for Environmental Outreach and Education

Public trust in organizations focused on improving environmental quality is important for increasing awareness and changing behaviors that have water quality implications. Few studies have addressed trust in soil and water quality information sources, particularly for both agricultural and nonagricultural respondents of the same watersheds. Surveys in 19 watersheds across five states in the Midwest assessed trust in, and familiarity with, soil and water quality information sources. Overall, respondents most trusted University Extension, Soil and Water Conservation Districts, and the Natural Resource Conservation Service, while lawn care companies, environmental groups, and land trusts were less trusted. Significant differences in trusted sources were found between watersheds, and between agricultural and nonagricultural respondents across and within watersheds. Among agricultural respondents, a clear relationship exists between familiarity and trust; as familiarity with an organization increases, so too does level of trust. This relationship is less clear‐cut for nonagricultural respondents in this region. We highlight implications of these findings for soil and water quality outreach efforts.