Disparities in the prevalence of smoke alarms in U.S. households: Conclusions drawn from published case studies

Introduction

Deaths from fires and burns are a leading cause of fatal home injury in the United States. Smoke alarms are one of the most effective interventions to prevent residential fire deaths. Nationwide, more than 95% of homes are estimated to have at least one smoke alarm. There is evidence that homes at highest risk of fire deaths lag behind national averages in smoke alarm use and maintenance.

Method

We compiled a comprehensive list of published studies that focus on smoke alarm prevalence in high-risk homes. Our findings show that there are substantial gaps in both smoke alarm presence and functional status between high-risk homes and national average estimates.

Conclusions

To save more lives, improved efforts are needed to reduce the disparity in smoke alarm prevalence and functional use in the United States.     

Prenatal ultrasound finding of atypical genitalia: Counseling,genetic testing and outcomes

Objective

To report uptake of genetic counseling (GC) and prenatal genetic testing after the finding of atypical genitalia on prenatal ultrasound (US) and the clinical and genetic findings of these pregnancies.

Methods

A retrospective cohort study (2017–2019) of atypical fetal genitalia in a large expert center for disorders/differences of sex development. We describe counseling aspects, invasive prenatal testing, genetic and clinical outcome of fetuses apparently without [group 1, n = 22 (38%)] or with [group 2, n = 36 (62%)] additional anomalies on US.

Results

In group 1, 86% of parents opted for GC versus 72% in group 2, and respectively 58% and 15% of these parents refrained from invasive testing. Atypical genitalia were postnatally confirmed in 91% (group 1) and 64% (group 2), indicating a high rate of false positive US diagnosis of ambiguous genitalia. Four genetic diagnoses were established in group 1 (18%) and 10 in group 2 (28%). The total genetic diagnostic yield was 24%. No terminations of pregnancy occurred in group 1.

Conclusions

For optimal care, referral for an expert fetal US scan, GC and invasive diagnostics including broad testing should be offered after prenatal detection of isolated atypical genitalia.     

Significantly higher number of fetal cells in the maternal circulation of women with pre-eclampsia

Although the pathophysiology of pre-eclampsia is unknown, several studies have indicated that abnormal placentation early in pregnancy might play a key role. It has recently been suggested that this abnormal placentation may result in transfusion of fetal cells (feto-maternal transfusion) in women with pre-eclampsia. In the present study, fetal nucleated red blood cells were isolated from 20 women with pre-eclampsia and 20 controls using a very efficient magnetic activated cell sorting (MACS) protocol. The number of male cells was determined using two-color fluorescence in situ hybridization (FISH) for X and Y chromosomes. Significantly more XY cells could be detected in women with pre-eclampsia (0.61±1.2 XY cells/ml blood) compared to women with uncomplicated pregnancies (0.02±0.04 XY cells/ml blood) (Mann–Whitney U-test, p<0.001). These results suggest that fetal cell trafficking is enhanced in women with pre-eclampsia, and this finding may contribute to the understanding of the pathophysiology of the disease. Copyright © 2001 John Wiley & Sons, Ltd.     

Geochemical anomalies in two sulfide-bearing waste disposal areas: Fe,Cu, Zn,Cd, Pb,and As in contaminated waters and snow,Kemerovo and Chelyabinsk regions,Russia

Sulfide-bearing mill wastes are sources of high concentrations of acid, soluble metals, Sb, and As. Contents of Cu, Zn, Fe, Pb, Cd, As, and Sb in wastes of the Belovo Zn-processing and the Karabash mineral-processing plants (Russia) exceed the average content in the upper continental crust and background soils. High-dissolved metal and As concentrations are found in acid drainages, which form as a result of interaction between sulfide wastes and water. Monitoring research using geochemical and geophysical methods was performed to evaluate the contamination of the surrounding area (water and bottom sediments in the contaminated rivers and snow cover). Zones of geochemical anomalies were identified where the concentrations of Fe, Cu, Zn, Cd, Pb, and As are 2–3 orders of magnitude higher than in drinking water standards (for rivers) and background levels (for snow). The use of geophysical methods allowed us to prove penetration of drainage solutions into the groundwaters. The total environmental damage caused by the pollution of water and land resources in the Belovo Zn-processing plant waste disposal area amounted to $156 million at the time of 2011, and could reach $480 million by 2030, if steps are not taken in recycling and remediation of disturbed areas.