The development of the fetal eye: In utero ultrasonographic measurements of the vitreous and lens

Our objective was to establish nomograms for fetal eye measurements from 12 weeks' gestation by using transvaginal and transabdominal high-resolution ultrasound techniques. A prospective cross-sectional study was performed on 450 normal singleton pregnancies between 12 and 37 weeks' gestation. Vitreous and lens circumferences were measured by transvaginal ultrasonography until 17 weeks, and by abdominal ultrasound between 18 and 37 weeks' gestation. Regression analyses were used to create nomograms, and several transformations were done to obtain linearity. Eye measurements of 12 fetuses at risk for ocular disturbances were plotted on the constructed nomograms. Linear relationships were fitted between vitreous (r²=0.79) and lens (r²=0.88) circumferences and gestational age. In addition, there was a significant correlation between these measurements and the biparietal diameter. Data of the fetuses at risk showed that disturbances in ocular growth were associated mainly with abnormal cerebral development. These normative data may be helpful in the prenatal diagnosis of suspected congenital syndromes that include, among their manifestations, ocular growth disturbances such as microphthalmos and anophthalmos.     

Body Mass Index (BMI) as a first-line screening criterion for detection of excessive daytime sleepiness among professional drivers

OBJECTIVES: Obstructive sleep apnea (OSA) is the main predisposing factor of excessive daytime sleepiness (EDS), and, therefore, increases the risk of road crashes. However, it is difficult to rely on medical intake for OSA or fatigue since drivers' symptoms reports are not reliable. On the other hand, direct measurement of EDS among large numbers of drivers carries serious practical drawbacks. Obstructive sleep apnea, in turn, is strongly related to obesity, and elevated body mass index (BMI) is considered one of the major risk factors for OSA. Thus, it could be postulated that BMI may carry predictive value for EDS proneness. METHODS: The present study examined the interrelation between BMI, degree of OSA, as measured with Respiratory Distress Index (RDI), and the degree of EDS, as measured with the mean sleep onset latency in the Multiple Sleep Latency Test (MSLT) among obese (BMI = 32) professional drivers. The drivers went through polysomnography followed by the five sessions of MSLT in the next day. RESULTS: In accordance with prior studies, we have found strong correlation between BMI and the degree of OSA on the one hand, and between the degree of OSA and EDS on the other hand. OSA was detected among 77.7% of the drivers, 47.1% were sleepy, 19% had severe sleepiness [mean sleep latency [MSL < or = 5 min.], 28.1% had moderate sleepiness [MSL < or = 10 min.]. None of the drivers complained about any sleep problem, including snoring, and all reported that they do not experience excessive daytime sleepiness. Thus, there was no correlation between their subjective report and objective findings. CONCLUSIONS: Obese drivers with BMI above 32 are highly prone to be sleepy during the day. Their subjective reports of OSA or fatigue symptoms are not reliable. Therefore it is highly recommended to screen them easily by weight and height measure for further sleep study and decision about their driving abilities.     

Abiotic behavior of entrapped petroleum products in the subsurface during leaching

Petroleum products are generally volatile hydrocarbon mixtures. These mixtures may contaminate land surfaces, the unsaturated zone and ground waters at numerous sites and thus represent a long-term source of environmental subsurface pollution. Based on laboratory and field evidence obtained by our research groups and others we emphasize in the present review paper the effect of leaching on the abiotic processes controlling the fate of volatile petroleum hydrocarbon mixtures (VPHMs) in the soil environment. The modification of petroleum hydrocarbon mixtures due to changes in the soil water content is considered the result of a “leaching phenomenon”. The experimental evidence of VPHM behavior in the porous media is linked to four major processes: retention, redistribution and attenuation in the subsurface, and dissolution in the soil water.

Once VPHMs reach the soil surface, their residual concentration and composition is influenced by the amount and quality of the leaching water. The transport and natural attenuation of the VPHMs in the unsaturated zone is affected by the amount and rate of leaching. Since VPHM are a mixture of volatile and non-volatile hydrocarbons whose components differ by several orders of magnitude in their vapor pressure and water solubility, their fates in the soil environment under leaching will be diverse too. This will influence the temporal concentrations of the VPHM components and their distributions with depth, as vapors, solutes, or water-immiscible solutions. Wetting the soil before or after the VPHMs reach it, differentially affects the abiotic processes governing petroleum products behavior into the porous media.     

Outdoor experiments on enhanced volatilization by venting of kerosene component from soil

The effect of soil properties on the retention of kerosene in soils, at equilibrium and under venting, was studied. Eleven soils were studied, which represent a wide range of chemical properties and mechanical composition. The retention of kerosene in dry soils ranges from 3.5 to 18.1 mL/(100 g), and was related linearly to clay, silt and organic matter (OM) contents. A coarsely-aggregated dry vertisol (2–5 mm aggregates) retained half as much kerosene as its finely-aggregated (<2 mm) counterpart. Moisture content had a strong inverse effect on kerosene retention. The soil factors that inversely affected kerosene retention also enhanced kerosene stripping by venting. Of these, soil aggregation and porosity were the most important. In addition, kerosene volatilized faster and more completely from an initially moist soil, as compared with an initially dry soil. Differential volatilization of lighter components of kerosene changed the chemical composition of the residue in the soil substantially, as compared with the initial composition.     

Urban daily life routines and human exposure to environmental discomfort

This study suggests a shift in focus from studying environmental discomfort in urban strategic stations, from which average results for the city or specific results for selected sites are deduced, and from measuring environmental conditions in fixed monitoring stations to a study in which we monitor, with mobile portable sensors, the exposure of people to environmental sources of discomfort while performing their daily life activities. Significant variations in sense of discomfort were measured in this study, and almost half of this variability was found to be explained while four independent environmental variables were considered: air quality (concentrations of CO), noise level, climatic variables (thermal load), and social loads. The study conducted in the city of Tel Aviv, which suffers from hot, humid summers and cool winters, and noise levels that reach the average levels of 85 dB, and relatively lower levels of exposure to the other potential stressors. These levels of combined exposures result in moderate levels of discomfort for young, healthy people once they experience the more stressing environments in the city. It is shown also that noise from other people is the most salient source of discomfort in Tel Aviv. Levels of discomfort accumulate during the working hours, either due to the impact of social loads or noise, but the subjects showed good coping abilities that enabled them to recover in late afternoons. It seems that thermal load does not have immediate impact, but rather cumulative ones, mainly during transitional seasons when subjects are less adaptive to extreme changes in weather.     

Exposure of motorcycle,car and bus commuters to carbon monoxide on a main road in the Tel Aviv metropolitan area,Israel

Short-term personal exposure of passengers in different types of motor vehicles to carbon monoxide was investigated in an intensively used main road in Israel’s Tel Aviv metropolitan area. According to monitoring stations of the Ministry for Environmental Protection (MEP), concentrations of carbon monoxide (CO) along the road, at a height of 3 m above pedestrian level, in the Tel Aviv metropolitan area, are currently very low. However, these measurements do not reflect the actual exposure of commuters, which were the main objective of this study. Four vehicle types/travel modes were investigated: private cars with closed windows, private cars with open windows, motorcycles, and buses. The commuter CO average exposure was the accumulative exposure divided by the duration of the sampling taken along the route, for each type of vehicles. The results showed that commuters in cars with closed windows were exposed to the highest mean CO level, 27.2 ppm, for a period of 38 min; those in a car with open windows, to 19.7 ppm for 38 min; motorcycle riders, to 12.8 ppm, for 17 min; and bus users were exposed to the lowest mean pollution level, of only 3.6 ppm, for 25 min. Thus, CO values of 1 to 3 ppm, as measured at an MEP adjacent monitoring station, may indicate the exposure to CO pollution of area residents, but do not represent the actual exposure of commuters on the congested main road.     

The significance of a small, level-3 'semi evacuation' hospital in a terrorist attack in a nearby town

Terrorist attacks can occur in remote areas causing mass-casualty incidents MCIs far away from level-1 trauma centres. This study draws lessons from an MCI pertaining to the management of primary and secondary evacuation and the operational mode practiced. Data was collected from formal debriefings during and after the event, and the medical response, interactions and main outcomes analysed using Disastrous Incidents Systematic Analysis through Components, Interactions and Results (DISAST-CIR) methodology. A total of 112 people were evacuated from the scene-66 to the nearby level 3 Laniado hospital, including the eight critically and severely injured patients. Laniado hospital was instructed to act as an evacuation hospital but the flow of patients ended rapidly and it was decided to admit moderately injured victims. We introduce a novel concept of a 'semi-evacuation hospital'. This mode of operation should be selected for small-scale events in which the evacuation hospital has hospitalization capacity and is not geographically isolated. We suggest that level-3 hospitals in remote areas should be prepared and drilled to work in semi-evacuation mode during MCIs.