Rapid and radical amniodrainage in the treatment of severe twin–twin transfusion syndrome†

We have evaluated the role of a rapid and radical method of amniodrainage in the treatment of severe twin–twin transfusion. The outcome of 15 patients with severe twin–twin transfusion for which a amniodrainage was performed by means of a vacuum bottle system was compared with the outcome of 15 patients with a similar condition, matched for gestational age at the time of the initial procedure and drained using a standard procedure. In the study group the amniodrainage ended when no amniotic fluid could be aspirated, whereas the women in the standard group were drained with a syringe system and the fluid was removed until the deepest amniotic fluid pool was <8 cm. At the initial procedure, the mean volume of amniotic fluid drained was significantly (p<0.05) higher (3252 vs 2153 ml) and the length of the procedure significantly (p<0.001) shorter (21 vs 41 min) in the study group than in the standard group. The mean post-procedure amniotic fluid index was significantly (p<0.001) smaller (2.9 vs 7.7 cm) after radical amniodrainage than after the standard amniodrainage. The mean number of procedures was significantly (p<0.001) lower (1.5 vs 5.6) in the study group compared to the standard group. In the study group the mean placental thickness increased significantly (p<0.001) from 9 mm before the procedure to 49 mm after, and the overall perinatal survival rate was 80% and the proportion of pregnancies with at least one survivor was 93%. The present data indicate that early, rapid and radical amniodrainage is an effective and low-cost therapy for severe twin–twin transfusion syndrome. Compared to the standard amniodrainage technique it also appears to reduce the need for multiple procedures. Copyright © 2001 John Wiley & Sons, Ltd.     

Mapping afforestation and deforestation from 1974 to 2012 using Landsat time-series stacks in Yulin District, a key region of the Three-North Shelter region, China

The Three-North Shelter Forest Program is the largest afforestation reconstruction project in the world. Remote sensing is a crucial tool to map land use and land cover change, but it is still challenging to accurately quantify the change in forest extent from time-series satellite images. In this paper, 30 Landsat MSS/TM/ETM+ epochs from 1974 to 2012 were collected, and the high-quality ground surface reflectance (GSR) time-series images were processed by integrating the 6S atmosphere transfer model and a relative reflectance normalization algorithm. Subsequently, we developed a vegetation change tracking method to reconstruct the forest change history (afforestation and deforestation) from the time-series Landsat GSR images based on the integrated forest z-score (IFZ) model by Huang et al. (2009a), which was improved by multi-phenological IFZ models and the smoothing processing of IFZ data for afforestation mapping. The mapping result showed a large increase in the extent of forest, from 380,394 ha (14.8 % of total district area) in 1974 to 1,128,380 ha (43.9 %) in 2010. Finally, the land cover and forest change map was validated with an overall accuracy of 89.1 % and a kappa coefficient of 0.858. The forest change time was also successfully retrieved, with 22.2 % and 86.5 % of the change pixels attributed to the correct epoch and within three epochs, respectively. The results confirmed a great achievement of the ecological revegetation projects in Yulin district over the last 40 years and also illustrated the potential of the time-series of Landsat images for detecting forest changes and estimating tree age for the artificial forest in a semi-arid zone strongly influenced by human activities.     

Concentrations of mobile source air pollutants in urban microenvironments

Human exposures to criteria and hazardous air pollutants (HAPs) in urban areas vary greatly due to temporal-spatial variations in emissions, changing meteorology, varying proximity to sources, as well as due to building, vehicle, and other environmental characteristics that influence the amounts of ambient pollutants that penetrate or infiltrate into these microenvironments. Consequently, the exposure estimates derived from central-site ambient measurements are uncertain and tend to underestimate actual exposures. The Exposure Classification Project (ECP) was conducted to measure pollutant concentrations for common urban microenvironments (MEs) for use in evaluating the results of regulatory human exposure models. Nearly 500 sets of measurements were made in three Los Angeles County communities during fall 2008, winter 2009, and summer 2009. MEs included in-vehicle, near-road, outdoor, and indoor locations accessible to the general public. Contemporaneous 1- to 15-min average personal breathing zone concentrations of carbon monoxide (CO), carbon dioxide (CO₂), volatile organic compounds (VOCs), nitric oxide (NO), nitrogen oxides (NO_x), particulate matter (<2.5 μm diameter; PM_2.5) mass, ultrafine particle (UFP; <100 nm diameter) number, black carbon (BC), speciated HAPs (e.g., benzene, toluene, ethylbenzene, xylenes [BTEX], 1,3-butadiene), and ozone (O₃) were measured continuously. In-vehicle and inside/outside measurements were made in various passenger vehicle types and in public buildings to estimate penetration or infiltration factors. A large fraction of the observed pollutant concentrations for on-road MEs, especially near diesel trucks, was unrelated to ambient measurements at nearby monitors. Comparisons of ME concentrations estimated using the median ME/ambient ratio versus regression slopes and intercepts indicate that the regression approach may be more accurate for on-road MEs. Ranges in the ME/ambient ratios among ME categories were generally greater than differences among the three communities for the same ME category, suggesting that the ME proximity factors may be more broadly applicable to urban MEs.

Implications:Estimates of population exposure to air pollutants extrapolated from ambient measurements at ambient fixed site monitors or exposure surrogates are prone to uncertainty. This study measured concentrations of mobile source air toxics (MSAT) and related criteria pollutants within in-vehicle, outdoor near-road, and indoor urban MEs to provide multipollutant ME measurements that can be used to calibrate regulatory exposure models.     

Optimization-Based Atmospheric Plume Source Identification

This work applies optimization and an Eulerian inversion approach presented by Bagtzoglou and Baun in 2005 in order to reconstruct contaminant plume time histories and to identify the likely source of atmospheric contamination using data from a real test site for the first time. Present-day distribution of an atmospheric contaminant plume as well as data points reflecting the plume history allow the reconstruction and provide the plume velocity, distribution, and probable source. The method was tested to a hypothetical case and with data from the Forest Atmosphere Transfer and Storage (FACTS) experiment in the Duke experimental forest site. In the scenarios presented herein, as well as in numerous cases tested for verification purposes, the model conserved mass, successfully located the peak of the plume, and managed to capture the motion of the plume well but underestimated the contaminant peak.     

A uniform fish consumption advisory protocol for the Ohio River

ORSANCO and the six Ohio River main stem states have been working to align states' fish consumption advisories (FCAs) to enhance the value of advice issued to the public. To achieve this goal, ORSANCO worked closely with a panel consisting of state and USEPA representatives. The result of this effort is the Ohio River Fish Consumption Advisory Protocol (ORFCAP). The ORFCAP represents a single set of variables agreed upon by the panel that allows for a standardized protocol to create advisory thresholds to which states can defer to issue consumption advice for the Ohio River. The ORFCAP identifies ORSANCO as a clearinghouse for data which will be distributed to the panel for decision making. Other components include identifying primary contaminants of concern (PCBs and mercury) and dividing the river into four reporting units. The protocol was developed to issue FCAs for the protection of sensitive populations using five advisory groupings for PCBs and four for mercury. Specific variables used in the calculation of advisory thresholds such as health protection values, cooking reductions, average meal sizes, etc., were selected by the panel. Lastly, the protocol calls for FCA decisions to be based on analysis of the most recent 10?years of data for each species in each reporting unit to determine size class needs and advisory groupings. Upon pending implementation of the protocol by the main stem states, these decisions will be made annually through a series of discussions involving ORSANCO, the panel, and other appropriate state personnel.     

Sulphate, Nitrogen and Base Cation Budgets at 21 Forested Catchments in Canada, the United States and Europe

To assess the concern over declining base cation levels in forest soils caused by acid deposition, input-output budgets (1990s average) for sulphate (SO₄), inorganic nitrogen (NO₃-N; NH₄-N), calcium (Ca), magnesium (Mg) and potassium (K) were synthesised for 21 forested catchments from 17 regions in Canada, the United States and Europe. Trend analysis was conducted on monthly ion concentrations in deposition and runoff when more than 9 years of data were available (14 regions, 17 sites). Annual average SO₄ deposition during the 1990s ranged between 7.3 and 28.4 kg ha⁻¹ per year, and inorganic nitrogen (N) deposition was between 2.8 and 13.8 kg ha⁻¹ per year, of which 41–67% was nitrate (NO₃-N). Over the period of record, SO₄ concentration in deposition decreased in 13/14 (13 out of 14 total) regions and SO₄ in runoff decreased at 14/17 catchments. In contrast, NO₃-N concentrations in deposition decreased in only 1/14 regions, while NH₄-N concentration patterns varied; increasing at 3/14 regions and decreasing at 2/14 regions. Nitrate concentrations in runoff decreased at 4/17 catchments and increased at only 1 site, whereas runoff levels of NH₄-N increased at 5/17 catchments. Decreasing trends in deposition were also recorded for Ca, Mg, and K at many of the catchments and on an equivalent basis, accounted for up to 131% (median 22%) of the decrease in acid anion deposition. Base cation concentrations in streams generally declined over time, with significant decreases in Ca, Mg and K occurring at 8, 9 and 7 of 17 sites respectively, which accounted for up to 133% (median 48%) of the decrease in acid anion concentration. Sulphate export exceeded input at 18/21 catchments, likely due to dry deposition and/or internal sources. The majority of N in deposition (31–100%; median 94%) was retained in the catchments, although there was a tendency for greater NO₃-N leaching at sites receiving higher (<7 kg ha^-1 per year) bulk inorganic N deposition. Mass balance calculations show that export of Ca and Mg in runoff exceeds input at all 21 catchments, but K export only exceeds input at 16/21 sites. Estimates of base cation weathering were available for 18 sites. When included in the mass balance calculation, Ca, Mg and K exports exceeded inputs at 14, 10 and 2 sites respectively. Annual Ca and Mg losses represent appreciable proportions of the current exchangeable soil Ca and Mg pools, although losses at some of the sites likely occur from weathering reactions beneath the rooting zone and there is considerable uncertainty associated with mineral weathering estimates. Critical loads for sulphur (S) and N, using a critical base cation to aluminium ratio of 10 in soil solution, are currently exceeded at 7 of the 18 sites with base cation weathering estimates. Despite reductions in SO₄ and H⁺ deposition, mass balance estimates indicate that acid deposition continues to acidify soils in many regions with losses of Ca and Mg of primary concern. The U.S. Government's right to retain a non-exclusive, royalty free licence in and to any copyright is acknowledged. The Canadian Crown reserves the right to retain a non-exclusive, royalty free licence in and to any copyright.     

Organic contaminants in the Firth of Clyde following the cessation of sewage sludge dumping

To assess contaminant concentrations in the Firth of Clyde in relation to the former sewage sludge dump site at Garroch Head, and investigate any temporal changes, fish have been sampled annually since 1992 and sediment since 1999. In addition, a further four locations in the Clyde (Holy Loch, Hunterston, Skelmorlie and Irvine Bay) have been sampled for fish and sediment since 1999. Chlorobiphenyls (CBs) were measured in fish samples and polycyclic aromatic hydrocarbons (PAHs) and CBs in sediment. Since sampling was initiated the concentration for the summation operatorICES7 CBs in fish liver has been consistently >500 microg kg(-1) lipid weight at Garroch Head and the other Clyde sites and lower at the reference sites (Pladda, Colonsay, Broad Bay). Although the lowest CB concentrations of the eleven year period in plaice liver from Garroch Head were found in 2002, CB concentrations were found not to have decreased significantly since sewage sludge dumping ceased in 1998. However, a change in CB profile was observed with fish liver collected between 1992 and 1998 from Garroch Head showing a lower proportion of the less chlorinated CBs compared to the 1999-2002 liver samples. Highest CB and PAH concentrations in sediment were found at Garroch Head and Holy Loch with concentrations at these sites being significantly higher than at all other sites.     

The relationship between sustainable development and resource use from a geographic perspective

Geography provides the basic building blocks for the study of resource use and sustainable development, inasmuch as it categorizes the human environment. Within the environment are resources that are needed for the survival of society. As resources are largely limited and finite, humans as agents of change must employ techniques that allow an efficient and lasting use of the available resources in their environment. This paper discusses the nexus between geography, resource exploitation, use, and sustainable development. It also discusses the characteristics, types, and classification of resources, development and sustainable development as well as the challenges and strategies for attaining sustainable development, particularly in developing countries.     

Uncertainty Models for Estimates of Physical Characteristics of River Segments Over Large Areas

Spatially comprehensive estimates of the physical characteristics of river segments over large areas are required in many large‐scale analyses of river systems and for the management of multiple basins. Remote sensing and modeling are often used to estimate river characteristics over large areas, but the uncertainties associated with these estimates and their dependence on the physical characteristics of the segments and their catchments are seldom quantified. Using test data with varying degrees of independence, we derived analytical models of the uncertainty associated with estimates of upstream catchment area (CA), segment slope, and mean annual discharge for all river segments of a digital representation of the hydrographic network of France. Although there were strong relationships between our test data and estimates at the scale of France, there were also large relative local uncertainties, which varied with the physical characteristics of the segments and their catchments. Discharge and CA were relatively uncertain where discharge was low and catchments were small. Discharge uncertainty also increased in catchments with large rainfall events and low minimum temperature. The uncertainty of segment slope was strongly related to segment length. Our uncertainty models were consistent across large regions of France, suggesting some degree of generality. Their analytical formulation should facilitate their use in large‐scale ecological studies and simulation models.