You Eat What You Are: Moral Dimensions of Diets Tailored to One's Genes

Thanks to developments in genomics,dietary recommendations adapted to genetic riskprofiles of individual persons are no longerscience fiction. But what are the consequencesof these diets? An examination of possibleimpacts of genetically tailor-made diets raisesmorally relevant concerns that are analogous to(medical-ethical) considerations aboutscreening and testing. These concerns oftengive rise to applying norms for informedconsent and for the weighing of burdens andbenefits. These diets also have a broaderimpact, especially because food patterns arefull of personal, social and cultural meanings.Diets will change one's food patterns and one'sattitude towards food, and this may implychanges in one's identity. We argue that suchan impact does not necessarily raise moralproblems. Moral concerns are, however, relevantif collective values and shared meanings infood practices are at issue. Therefore, thedevelopment of genetically tailor-made dietsdoes not merely require emphasis on weighingpersonal benefits and burdens and on informedconsent. It also asks for attention to andmoral reflection on the collective valuesinvolved in food practices.     

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.