Is the first-trimester combined screening result associated with the phenotype of Down syndrome? A population-based cohort study

Objective

To investigate if the Down syndrome phenotype differs according to the result of first-trimester combined screening (FTS).

Method

We included all Down syndrome cases diagnosed by karyotype in pregnancy or after birth in Denmark during 2005–2018. We compared screen positive (odds ≥1:300) and screen negative (odds <1:300) cases as well as screen result subgroups with respect to anthropometrics, congenital malformations, childhood diseases, and hospitalization.

Results

Absolute measures of fetal and birth anthropometrics were comparable between groups. A prenatal malformation diagnosis was more prevalent among screen positive than screen negative cases. Analyses suggested that this could reflect a detection bias. Cases with a screen result of 1:2–1:10 had a higher probability of being diagnosed with a malformation prenatally and with severe congenital heart disease (CHD) postnatally compared with a result of 1:11–1:300. Screen positive cases more often had non-severe CHD but less often a non-heart malformation compared with screen negative cases, while proportions of severe CHD were similar in these groups. Data on hospitalizations showed inconsistent results.

Conclusion

The 1:300 screening threshold had limited or no value in predicting Down syndrome phenotype severity. In contrast, cases with a screen result between 1:2 and 1:10 may represent a more severe phenotype.     

城市污水污泥对环境的污染及其防治

本文论述了城市污水污泥对水源和土壤的污染,并对其污泥特性作了分析,指出在我国的现有条件下污泥的处置主要为农业上的利用.     

A VIABLE METHODOLOGY TO IMPLEMENT THE PRINCIPLES AND STANDARDS1

ABSTRACT: The “principles and standards for planning water and related land resources” were made effective October 25, 1973. The document was noticeably deficient in suggestions for the necessary implementing procedures to ensure its success. Current implementing procedures are based on an incorrect premise of maximizing a single objective subject to non-quantified constraints. A successful implementation of multiple objective planning requires optimizing simultaneously several competitive goals. A system of goal programming has been developed and applied to decisionmaking situations as a test of its usefulness in planning for multiple objective water resources projects. The result is a project planning process which can be replicated for adjustments in expected resource supplies or demands to provide a tradeoff matrix between economic and environmental objectives as well as traditional functional purposes. This procedure, tested on the Cross Florida Barge Canal, is an integrated analysis of economic and environmental values which may be as effective in implementing multiple objective planning as the “Green Book” was in developing the now inappropriate benefit cost analysis.     

唐山市工业区大气污染对小学生肺功能的影响

探讨了工业区大气污染对小学生肺功能的影响。在唐山市工业区和相对清洁区选取452名小学生为研究对象,进行肺功能的测定和问卷调查。用多元回归分析建立模型后,以实测值占预计值的百分比为统计量进行分析。调查结果显示小学生肺功能指标中MVV、V25污染区低于对照区,VC、FEV、V25、V50的异常率高于对照区,且与大气中SO2的浓度有关。     

An agent based model to simulate structural and land use changes in agricultural systems of the argentine pampas

The Argentine Pampas, one of the main agricultural areas in the world, recently has undergone significant changes in land use and structural characteristics of agricultural production systems. Concerns about the environmental and societal impacts of the changes motivated development of an agent-based model (ABM) to gain insight on processes underlying recent observed patterns. The model is described following a standard protocol (ODD). Results are discussed for an initial set of simplified simulations performed to understand the processes that generated and magnified the changes in the Pampas. Changes in the structure of agricultural production and land tenure seem to be driven by differences among farmers’ ability to generate sufficient agricultural income to remain in business. In turn, as no off-farm or credit is modeled, economic sustainability is tied to initial resource endowment (area cropped). Farmers operating small areas are economically unviable and must lease out their farms to farmers operating larger areas. This leads to two patterns: (a) a concentration of production (fewer farmers operating larger areas) and, (b) an increase in the area operated by tenants. The simulations showed an increase of soybean area, linked to the higher profitability of this crop. Despite the stylized nature of initial simulations, all emerging patterns are highly consistent with changes observed in the Pampas.