Current practice of first-trimester ultrasound screening for structural fetal anomalies in developed countries

Objectives

First-trimester ultrasound screening is increasingly performed to detect fetal anomalies early in pregnancy, aiming to enhance reproductive autonomy for future parents. This study aims to display the current practice of first-trimester ultrasound screening in developed countries.

Method

An online survey among 47 prenatal screening experts in developed countries.

Results

First-trimester structural anomaly screening is available in 30 of the 33 countries and is mostly offered to all women with generally high uptakes. National protocols are available in 23/30 (76.7%) countries, but the extent of anatomy assessment varies. Monitoring of scan quality occurs in 43.3% of the countries. 23/43 (53.5%) of the respondents considered the quality of first-trimester ultrasound screening unequal in different regions of their country.

Conclusions

First-trimester screening for structural fetal anomalies is widely offered in developed countries, but large differences are reported in availability and use of screening protocols, the extent of anatomy assessment, training and experience of sonographers and quality monitoring systems. Consequently, this results in an unequal offer to parents in developed countries, sometimes even within the same country. Furthermore, as offer and execution differ widely, this has to be taken into account when results of screening policies are scientifically published or compared.     

Birthweight of children with isolated congenital heart disease—A sibling analysis study

Objective

Congenital heart disease (CHD) is associated with decreased birthweight (BW) compared to population-based references. The aim of this study was to compare the BW of isolated CHD cases to their siblings, thus controlling for unknown and unmeasured confounders within the family.

Methods

All isolated CHD cases in the Leiden University Medical Center were included (2002–2019). Generalized estimated equation models were constructed to compare BW z scores of CHD neonates with their siblings. Cases were clustered to minor or severe CHD and stratified according to the aortic flow and oxygenation to the brain.

Results

The overall BW z score of siblings was 0.032 (n = 471). The BW z score was significantly lower in CHD cases (n = 291) compared to their siblings (−0.20, p = 0.005). The results were consistent in the subgroup analysis of severe and minor CHD (BW z score difference −0.20 and −0.10), but did not differ significantly (p = 0.63). Stratified analysis regarding flow and oxygenation showed no BW difference between the groups (p = 0.1).

Conclusion

Isolated CHD cases display a significantly lower BW z score compared to their siblings. As the siblings of these CHD cases show a BW distribution similar to the general population, this suggests that shared environmental and maternal influences between siblings do not explain the difference in BW.     

Box Handling in the Loading and Unloading of Vans

The handling of 2,306 boxes being loaded or unloaded from vans onto or from 4-wheeled trolleys by 31 handlers in a warehouse were characterized. Handling was videotaped and characterized through an analysis grid completed by three trained observers. The following execution parameters were observed: nature of the exertion applied by the upper limbs, plane and direction of the exertion, resulting displacement of the box, grip, use of the lower limbs and the back. Results show that execution parameters used by handlers vary considerably from those usually recommended or studied. For example, symmetric grips were rarely used (4%). The grip was modified during the handling of half the boxes. Significant knee flexion was rarely observed (3% of exertions). Each box was moved by applying an average of . 3.5 different exertions. Exertions were mostly applied in a plane parallel to the shoulders; they were rarely executed in a strict sagittal plane (11%). The implication of these observations are discussed.     

Circulating trophoblast in maternal blood

This review describes the status of circulating trophoblast, but is considered in the perspective that only a specific subset of trophoblast cells circulates in the maternal blood. The consequences for isolation, identification and clinical potential are described. Copyright © 2003 John Wiley & Sons, Ltd.     

Improving sustainability through effective reuse of product returns: minimizing waste in a batch blending process environment

A case study of a successful reuse program in a batch blending production environment is presented. This program involves not only addressing the company's own potential waste, but also working with distributors and customers to take back and reuse product, thus eliminating the customers' burden of disposal. Implications of the program for downstream supply chain partners are identified and a structured approach for implementation is presented. Modification for use in similar production environments is possible, enhancing sustainability, while providing environmental as well as economic benefits.     

Encapsulation of Nerol Oil in Polycaprolactone Polymer and Stability Evaluation

Journal of Polymers and the Environment - The objective of this study was to obtain and characterize Nerol essential oil encapsulated in PCL. The miniemulsion and solvent evaporation method was...     

Load Estimation Method Using Distributions with Covariates: A Comparison with Commonly Used Estimation Methods

Load estimates obtained using an approach based on statistical distributions with parameters expressed as a function of covariates (e.g., streamflow) (distribution with covariates hereafter called DC method) were compared to four load estimation methods: (1) flow‐weighted mean concentration; (2) integral regression; (3) segmented regression (the last two with Ferguson's correction factor); and (4) hydrograph separation methods. A total of 25 datasets (from 19 stations) of daily concentrations of total dissolved solids, nutrients, or suspended particulate matter were used. The selected stations represented a wide range of hydrological conditions. Annual flux errors were determined by randomly generating 50 monthly sample series from daily series. Annual and interannual biases and dispersions were evaluated and compared. The impact of sampling frequency was investigated through the generation of bimonthly and weekly surveys. Interannual uncertainty analysis showed that the performance of the DC method was comparable with those of the other methods, except for stations showing high hydrological variability. In this case, the DC method performed better, with annual biases lower than those characterizing the other methods. Results show that the DC method generated the smallest pollutant load errors when considering a monthly sampling frequency for rivers showing high variability in hydrological conditions and contaminant concentrations.     

Does pyrogenicity protect burning plants?

Pyrogenic plants dominate many fire-prone ecosystems. Their prevalence suggests some advantage to their enhanced flammability, but researchers have had difficulty tying pyrogenicity to individual-level advantages. Based on our review, we propose that enhanced flammability in fire-prone ecosystems should protect the belowground organs and nearby propagules of certain individual plants during fires. We base this hypothesis on five points: (1) organs and propagules by which many fire-adapted plants survive fires are vulnerable to elevated soil temperatures during fires; (2) the degree to which burning plant fuels heat the soil depends mainly on residence times of fires and on fuel location relative to the soil; (3) fires and fire effects are locally heterogeneous, meaning that individual plants can affect local soil heating via their fuels; (4) how a plant burns can thus affect its fitness; and (5) in many cases, natural selection in fire-prone habitats should therefore favor plants that burn rapidly and retain fuels off the ground. We predict an advantage of enhanced flammability for plants whose fuels influence local fire characteristics and whose regenerative tissues or propagules are affected by local variation in fires. Our "pyrogenicity as protection" hypothesis has the potential to apply to a range of life histories. We discuss implications for ecological and evolutionary theory and suggest considerations for testing the hypothesis.     

Practical guide to coproduction in conservation science

We considered a series of conservation-related research projects on the island of Pemba, Tanzania, to reflect on the broad significance of Beier et al.’s recommendations for linking conservation science with practical conservation outcomes. The implementation of just some of their suggestions can advance a successful coproduction of actionable science by small research teams. Key elements include, first, scientists and managers working together in the field to ensure feedback in real time; second, questions jointly identified by managers and researchers to facilitate engaged collaboration; third, conducting research at multiple sites, thereby broadening managers’ abilities to reach multiple stakeholders; and fourth, establishing a multidisciplinary team because most of the concerns of local managers require input from multiple disciplines.