The value of echocardiography and Doppler in the prediction of fetal demise after laser coagulation for TTTS: A systematic review and meta-analysis

This study aimed to investigate the value of echocardiography and Doppler before fetoscopic laser coagulation for twin-twin transfusion syndrome (TTTS) in the prediction of intrauterine fetal demise (IUFD). We performed a systematic review and meta-analysis to compare preoperative parameters between fetuses with and without demise after laser surgery. Eighteen studies were included. Recipient twins have an increased risk of demise in case of preoperative absent/reversed flow (A/REDF) in the umbilical artery (odds ratio [OR] 2.76, 95% confidence interval [CI], 1.78-4.28), absent or reversed a-wave in the ductus venosus (OR 2.32, 95% CI, 1.70-3.16), or a middle cerebral artery peak systolic velocity > 1.5 multiples of the median (MoM) (OR 7.59, 95% CI, 2.56-22.46). In donors, only A/REDF in the umbilical artery (OR 3.40, 95% CI, 2.68-4.32) and absent or reversed a-wave in the ductus venosus (OR 1.66, 95% CI, 1.12-2.47) were associated with IUFD. No association was found between donor-IUFD and preoperative myocardial performance index (MPI). Two studies found an association between abnormal MPI and recipient demise. With this study, we have identified a set of preoperative Doppler parameters predictive of fetal demise after laser surgery. More research is needed to assess the utility of preoperative echocardiographic parameters such as the MPI in predicting IUFD.     

Modelling concentrations of airborne primary and secondary PM10 and PM2.5 with the BelEUROS-model in Belgium

The Eulerian Chemistry-Transport Model BelEUROS was used to calculate the concentrations of airborne PM₁₀ and PM_2.5 over Europe. Both primary as well as secondary particulate matter in the respirable size-range was taken into account. Especially PM_2.5 aerosols are often formed in the atmosphere from gaseous precursor compounds. Comprehensive computer codes for the calculation of gas phase chemical reactions and thermodynamic equilibria between compounds in the gas-phase and the particulate phase had been implemented into the BelEUROS-model. Calculated concentrations of PM₁₀ and PM_2.5 are compared to observations, including both the spatial and daily, temporal distribution of particulate matter in Belgium for certain monitoring locations and periods. The concentrations of the secondary compounds ammonium, nitrate and sulfate have also been compared to observed values. BelEUROS was found to reproduce the observed concentrations rather well. The model was applied to assess the contribution of emissions derived from the sector agriculture in Flanders, the northern part of Belgium, to PM₁₀- and PM_2.5-concentrations. The results demonstrate the importance of ammonia emissions in the formation of secondary particulate matter. Hence, future European emission abatement policy should consider more the role of ammonia in the formation of secondary particles.     

Degradation of isobutanal at high loading rates in a compost biofilter

Biofiltration has been increasingly used for cleaning waste gases, mostly containing low concentrations of odorous compounds. To expand the application area of this technology, the biofiltration of higher pollutant loading rates has to be investigated. This article focuses on the biodegradation of isobutanal (IBAL) in a compost biofilter (BF) at mass loading rates between 211 and 4123 g/m3/day (30-590 ppm(v)). At mass loading rates up to 785 g/m3/day, near 100% removal efficiencies could be obtained. However, after increasing the loading rate to 1500-1900 g/m3/ day, the degradation efficiency decreased to 62-98%. In addition, a pH decrease and production of isobutanol (IBOL) and isobutyric acid (IBAC) were observed. This is the first report showing that an aldehyde can act as electron donor as well as acceptor in a BF. To study the effects of pH, compost moisture content, and electron acceptor availability on the biofiltration of IBAL, IBOL, and IBAC, additional batch and continuous experiments were performed. A pH of 5.2 reduced the IBAL degradation rate and inhibited the IBOL degradation, although adaptation of the microorganisms to low pH was observed in the BFs. IBAC was not degraded in the batch experiments. High moisture content (51%) initially had no effect on the IBOL production, although it negatively affected the IBAL elimination increasingly during a 21-day time-course experiment. In batch experiments, the reduction of IBAL to IBOL did not decrease when the amount of available electron acceptors (oxygen or nitrate) was increased. The IBAL removal efficiency at higher loading rates was limited by a combination of nutrient limitation, pH decrease, and dehydration, and the importance of each limiting factor depended on the influent concentration.     

Not All Animals are Equal Differences In Moral Foundations For The Dutch Veterinary Policy On Livestock and Animals In Nature Reservations

The Netherlands is a small country with many people and much livestock. As a result, animals in nature reservations are often living near cattle farms. Therefore, people from the agricultural practices are afraid that wild animals will infect domestic livestock with diseases like Swine Fever and Foot and Mouth Disease. To protect agriculture (considered as an important economic practice), very strict regulations have been made for minimizing this risk. In this way, the practice of animal farming has been dominating the practices of nature management completely. If, for instance, Foot and Mouth Disease strikes an agricultural area, all wild pigs and cattle living in the nearby nature reservations have to be killed, whether infected or not. This dominant position of one practice over the other has now become problematic. While the morality of the practice of nature management seems to be very different from the morality of agriculture and agriculture has become less important from an economic point of view, the public as well as those involved in nature management no longer seem to accept the dominant position of agriculture. Besides a literature study, we performed a field study with in-depth interviews with experts from both practices to analyze the dynamics of the internal moralities of both practices in the previous century, in order to clarify the contemporary situation. The conclusion was that the traditionally strong position of agriculture is not only weakening; it also appears that the internal values of agriculture are changing. The experts from both sides agreed that, in case of a disease outbreak, it is neither ethically justified nor necessary (because of the estimated low risk of disease transfer) to destroy the animals in nature reservations as a routine preventive measure. This is a major shift in morality.     

Drugs and driving

The authors present a global overview on the issue of drugs and driving covering four major areas: (1) Epidemiology and Prevalence--which reviews epidemiological research, summarizes available information, discusses the methodological shortcomings of extant studies, and makes recommendations for future research to better define prevalence and epidemiology; (2) Effects of Medicinal and Illegal Drugs on Driving Performance--focuses on the six classes of drugs most often found in impaired and injured drivers, draws conclusions regarding the risk of these drugs to traffic safety and discusses the need for additional research; (3) Toxicological Issues--discusses ways to identify drug users via behavioral testing and analytical techniques, reviews the approaches used by different countries, screening and confirmation techniques, alternative specimens (e.g., urine, oral fluid, sweat), and how rapid roadside testing could be coupled with behavioral and laboratory testing in an effective approach to identifying and prosecuting drugged drivers; (4) Driving Under the Influence of Drugs [DUID] Laws--provides an overview of DUID laws in the United States and Europe, discusses the basic tenets of these laws, the various types of DUID statutes, the reasons why many existing laws hinder the prosecution of drugged drivers and the rationale for developing per se legislation as a strategy to more effectively manage the drugged driver problem.     

A chromosome 21-specific cosmid cocktail for the detection of chromosome 21 aberrations in interphase nuclei

Fluorescent in situ hybridization (FISH) with a 21q11-specific probe (CB21c1) consisting of three non-overlapping cosmids has been applied to interphase amniocytes of pregnancies at increased risk for fetal aneuploidy (N = 78) and to interphase lymphocytes, cultured and uncultured, of patients referred for Down syndrome (N = 19 and 28, respectively). In the uncultured amniocytes, six chromosome aberrations were detected: three cases of trisomy 21, a triploidy, a de novo 46,XX,t(21q21q), and a mosaic 46,XY/47,XY,+dic(21)(q11)/48,XY,+dic(21)(q11), +del(21)(q11). In 15 cultured and 20 uncultured blood samples, FISH correctly diagnosed trisomy 21 (full or mosaic) at the interphase level, which was confirmed in all cases by subsequent karyotyping. Because of specific and strong signals in interphase nuclei, CB21c1 appears to be a useful tool for the rapid detection of chromosome 21 abnormalities.