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71.
We assessed the discriminatory efficiency and cost-effectiveness of a novel way of organising first trimester screening for Down syndrome (DS), contingent testing, where a serological test (PAPP-A and β-hCG: the double test) is made in early first trimester and followed by nuchal translucency testing (NT) only in women with an intermediate risk, e.g. <1:65 and >1:1000, and not in all women as in normal first trimester screening (NFTS). Using Monte Carlo simulation contingent testing had a detection rate (DR) of 78.9% and a false-positive rate (FPR) of 4.0% for DS with 19.4% of women offered NT testing. The DR of NFTS was 85.5% and the FPR 4.4%. The decrease in NT screening was associated with an increase from 23% to 29% in the proportion of DS cases born. The cost of the contingent testing programme was £53 000 per DS case not born and £91 000 in NFTS. The number of aborted fetuses per DS case were 0.35 and 0.36, respectively. Thus, contingent testing is an organisation of first trimester screening where costs can be reduced with a marginal decrease in performance. Contingent testing is attractive in areas where NT screening is the bottleneck preventing the introduction of first trimester screening. Copyright © 2002 John Wiley & Sons, Ltd. 相似文献
72.
73.
In order to elucidate the consistency between generally used age-dependent risk values for Down syndrome (DS) and estimates of the probability of miscarriage in Down pregnancies we have compared expected numbers with estimated numbers of births with DS in Denmark had no intervention at all been carried out. The expected numbers were calculated from the distribution of newborn children according to maternal age combined with the age-related risk of DS. The estimated numbers of children that actually would have been born without any intervention were estimated from observed numbers of cases of DS, i.e. the cases born plus – with corrections because of the high probability of miscarriage in DS pregnancies – a proportion of those cases discovered prenatally. The analysis was carried out separately for mothers aged 35 years or older and for younger mothers. We found a high degree of compatibility between expected and estimated numbers, probably with a minor underestimation of the expected values for the older mothers. The performance of DS screening in Denmark in the period under consideration (1980–1998) is discussed in relation to the figures presented. Despite the fact that 11.8% of all pregnancies were subjected to an invasive diagnostic procedure, only about 38% of all births with DS were prevented. This means that in the period 1990–1998, reluctance to accept serological screening has indirectly resulted in the birth of almost 300 cases of DS in Denmark and at the same time the miscarriage of an unreasonable high number of normal fetuses. Copyright © 2001 John Wiley & Sons, Ltd. 相似文献
74.
75.
Lee W. Cooper Jacqueline M. Grebmeier I. L. Larsen Scott S. Dolvin Andrew J. Reed 《Chemistry and Ecology》2013,29(1-3):27-46
Abstract Extensive surveys of sediment burdens of radiocaesium, specifically 137Cs, and other radioactive contaminants in the Arctic during the 1990′s, indicate that almost all anthropogenic radionuclides buried on continental shelves adjacent to Alaska are derived from global bomb fallout. the 137Cs (half-life: 30.2y) activities observed in surface (0–4 cm) marine sediments however, vary widely, albeit much less than the expected current inventory resulting from bomb fallout at this latitude (~100mBq cm?2). This observed geographical variation provided the opportunity to evaluate physical and biological mechanisms that may affect caesium biogeochemistry on Arctic continental shelves. We investigated whether high biological productivity in portions of the Bering and Chukchi Seas is effective in removing dissolved radiocaesium from the water column, and whether biological production in overlying water affects total radiocaesium inventories in sediments. Based upon C/N ratios in the organic fraction of shallow sediments, we found no evidence that higher inventories or surface activities of radiocaesium are present in areas with higher deposition of particulate organic matter. Based upon stable carbon isotope ratios of organic matter in sediments, we found no evidence that terrestrial runoff contributes proportionally to higher surface activities, although terrestrial runoff may affect total inventories of the radionuclide. Radiocaesium content of surface sediments was significantly correlated with total organic carbon content of sediments and the proportion of sediments in the finest sediment fractions. Because high current flow can also be expected to influence distributions of those sedimentary parameters, we conclude that re-distribution of 相似文献
76.
Larry Larsen Terri Morrell Gretchen Schalge Meghan Gallione Joseph Bell Kip Petersen Frederick Steiner 《Environmental management》1991,15(4):549-563
This article is the third in a series prepared to explain the Teller County growth management planning process. Once it was
determined by local decision-makers that Teller County, Colorado, would pursue a policy of directed growth, concepts based
on this policy were developed. These concepts presented visions and options for the future. Landscape plans then were developed
for Teller County and the City of Woodland Park planning area so that these options could be visualized by local leaders and
the public. The landscape plans were used as part of the ongoing citizen involvement process to inform the public about the
options for growth management. To provide even more information, detailed designs were developed for specific areas in the
county. From the landscape plan, public involvement effort, and detailed designs, specific implementation measures were identified,
discussed, and adopted. These measures included guidelines for administration, so that county and city goals could be linked
to the actual day-to-day management of development proposals.
Paper 3 in a series of 3. 相似文献
77.
James M. Omernik David P. Larsen Christina M. Rohm Sharon E. Clarke 《Environmental management》1988,12(6):815-825
A map of summer total phosphorus in lakes has been compiled for Minnesota, Wisconsin, and Michigan to clarify regional patterns in attainable lake trophic state. Total phosphorus was used as a measure of lake trophic state because: (1) phosphorus plays a central role in controlling the overall fertility of most lakes, (2) total phosphorus values are available for a great number of lakes, and (3) phosphorus is measured in a consistent manner. The maps were compiled using patterns of total phosphorus data and observed associations between these data and geographic characteristics including physiography, land use, geology, and soils. Regions depicted on the map represent areas of similarity in phosphorus concentrations in lakes, or similarity in the mosaic of values, as compared to adjacent areas. Within each region, differences in total phosphorus can be compared to natural and anthropogenic factors to determine the types of lakes representative of each region, the factors associated with differences in quality, and the realistically attainable phosphorus levels for each type of lake. 相似文献
78.
Particle trajectories of 6.4m Latex spheres were recorded by video, both near an isolated blue mussel, Mytilus edulis, gill filament and, in place of an intact interfilamentary canal, in a model canal of width 200, 100 or 70m, formed by a transparent plate positioned next to a gill filament. Each arrangement was placed in a 2 x 10 x 10 cm test vessel filled with seawater. Serotonin (nerve-transmitter) stimulation was used to activate lateral cilia and to either lock latero-frontal cirri at the end of an active stroke (10-5
M), or to activate them (10-6
M), yielding lateral cilia beat frequencies of 19 and 16 Hz, respectively. With latero-frontal cirri locked, image analysis of particle tracks gave maximum velocities of ca. 2.9±0.2mm s-1 close to the tips of lateral cilia, for both isolated filament and model canal cases. Experimental velocity profiles along the 200-m wide model canal were recorded and used as good approximations to the fluid velocity because of the low Reynolds number. A two-dimensional steady model was proposed for the gill pump, assumed to only comprise lateral cilia. This model was solved numerically for the experimental model, canal in the vessel and the results showed satisfactory agreement with experimental volocity profiles from particle tracks. The numerical approach was also applied to a model of a single interfilamentary canal in the vessel. The resulting mean velocity in the canal was 1.70 mm s-1, but the resistance to flow in the model was less than that in an intact mussel gill. Video graphs of particle tracks indicated that active latero-frontal cirri play a role in the transfer of particles from through current to frontal current, probably by means of a strong interaction through the motion of intervening fluid rather than through a direct physical contact. M. edulis specimens used in the present study were collected in 1990 at Helsingør and in 1991 at Kerteminde, Denmark. 相似文献
79.
Larsen RI 《Journal of the Air & Waste Management Association (1995)》2003,53(11):1326-1339
The Clean Air Act Amendments of 1990 (CAAA-90) list 189 hazardous air pollutants (HAPs) for which "safe" ambient concentrations are to be determined. The primary purpose of this paper is to develop two mathematical models, lognormal and logarithmic, that effectively express excess lung cancer mortality as a function of asbestos concentration for an example set of data and also to suggest using these two models for additional HAPs. The secondary purpose of this paper is to calculate a "safe" asbestos concentration by first assuming a default linear extrapolation (to one excess death per million people, as specified for carcinogenic HAPs). The resulting "safe" concentration is an impossible-to-achieve 1/1000 of present background asbestos concentrations. A letter to the editor and a response in this Journal issue use additional asbestos data that suggest that the "safe" concentration should be about 730 times higher than first calculated here and that a default nonlinear extrapolation should be used instead, with the "safe" concentration proportional to the desired mortality level raised to the 0.39 power. These results suggest that the most important problem in setting a "safe" concentration for each carcinogenic HAP is to determine the correct nonlinear extrapolation to use for each HAP. 相似文献
80.
Cod (Gadus morhua) were exposed to hypercapnia (water Pco2 = 7.5 mmHg), elevated copper level (0.4 ppm) or a combination of both in order to study extra- and intracellular acid-base
regulation and the influence hereupon of copper. During pure hypercapnia, the extracellular respiratory acidosis was completely
compensated within 12 to 24 h via a chloride-mediated increase in extracellular [HCO3
−]. Exposure to copper in normocapnic seawater caused a large and progressive increase in plasma [Na+] and [Cl−] and a metabolic acidosis. Exposure to copper in hypercapnic seawater was associated with smaller elevations of plasma [Na+] and [Cl−] than in normocapnic seawater, showing that hypercapnia had a protective effect on the copper-induced osmoregulatory disturbances.
The compensation of the hypercapnic acidosis was, however, slow and incomplete in fish exposed to both copper and hypercapnia.
Extracellular pH remained depressed by 0.3 pH units after 72 h. The data reveal that acid-base regulation was immediately
and persistently inhibited by copper. The limited acid-base regulation during combined copper and hypercapnia exposure was
chloride-mediated as during hypercapnia alone. Intracellular pH recovery was complete and very rapid in ventricular and skeletal
muscle tissues during environmental hypercapnia, whereas acid-base compensation in liver tissue was slower, the kinetics being
similar to that in the extracellular compartment. Intracellular pH compensation was significantly slowed down by copper. Copper
concentration increased drastically in gill tissue already at 3 h, while copper concentrations in liver, muscle and plasma
were significantly elevated only after 48 h, with liver showing the largest elevation.
Received: 15 November 1996 / Accepted: 2 December 1996 相似文献