Women as moral pioneers? Experiences of first trimester antenatal screening

Copyright @ 2005 Elsevier Ltd.The implementation of innovative medical technologies can raise unprecedented ethical, legal and social dilemmas. This is particularly so in the area of antenatal screening, which is dominated by the language of risk and probabilities. Second trimester serum screening for Down's syndrome and neural tube defects has a well-established place in antenatal care. Increasingly, first trimester screening with biochemical and ultrasound markers is being proposed as advance on this, yielding higher detection rates of Down's syndrome at an earlier gestational age. This article explores the experiences of 14 women offered innovative first trimester screening, which takes place within the context of a detailed ultrasound scan. The study is set within the UK, where recent policy changes mean that the offer of screening for fetal anomalies, particularly Down's syndrome, will become a routine part of antenatal care and offered to all pregnant women. This paper focuses on the significance of the scan in first trimester screening, and some of the potential dilemmas for women that can result from this. It then discusses the ways in which women made their decisions about screening, in particular, their work as ‘moral pioneers’. We found that the part played by the ultrasound scan in first trimester screening, particularly in relation to the higher-quality images now being obtained, has the potential to introduce new and novel ethical dilemmas for pregnant women. Although concerns have been raised about pregnant women viewing ultrasound scans as benign, many of the women reported having thought carefully through their own moral beliefs and values prior to screening. It seems that whatever other implications they may have, first trimester screening technologies will continue the tradition of pregnant women acting as ‘moral pioneers’ in increasingly complex settings.ESRC/MRC Innovative Health Technologies Programme for funding the project (grant no: L218252042). CW acknowledges the support of The Wellcome Trust Biomedical Ethics Programme in funding her postdoctoral fellowship, which enabled her to work on this project

СИНТЕЗ ТА ДОСЛІДЖЕННЯ АНТИТРИПАНОСОМНОЇ АКТИВНОСТІ НОВИХ 5-ІЛІДЕН-2-(1,3,4-ТІАДІАЗОЛ-2-ІЛ)ІМІНОТІАЗОЛІДИН-4-ОНІВ

The aim of work. Synthesize the new thiadiazolo-2-iminothiazolidin-4-ones and their 5-arylidene derivatives based on the heterocyclization reaction and Knoevenagel condensation and study their antitrypanosomal activity.Materials and Methods: organic synthesis, NMR spectroscopy, elemental analysis, pharmacological screening.Results and Discussion. Following the cyclization reaction of N-(1,3,4-thiadiazol-2-yl)substituted 2-chloroacetamides with ammonium thiocyanate in dry acetone the corresponding 2-imino-4-thiazolidinone derivatives have been obtained. Further chemical modification of synthesized methylene active 2-(1,3,4-thiadiazol-2-yl)imino-4-thiazolidinones was performed via Knoevenagel condensation with various aromatic or heterocyclic aldehydes, isatin or cinnamic aldehyde derivatives have yielded a series of 5-aryl(heteryl)ylidene- and 5-isatin(3-phenylpropene)ylidene derivatives as potential antitrypanosomal agents. The structure of obtained compounds was confirmed by NMR spectroscopy and elemental analysis.Conclusions. The results of in vitro screening of antitrypanosomal activity against Trypanosoma brucei gambiense (TBG) allowed us to identify four highly active compounds which owned essential trypanocidal effect with a range of values IC50 within 7.3-12.8 µM.Мета роботи. На основі реакцій гетероциклізації та Кньовенагеля здійснити синтез нових тіадіазоло-2-імінотіазолідин-4-онів та їх 5-ариліденпохідних для скринінгу антитрипаносомної активності.Матеріали і методи. Органічний синтез, спектроскопія ЯМР, елементний аналіз, фармакологічний скринінг.Результати й обговорення. Циклізацією N-(1,3,4-тіадіазол-2-іл)заміщених 2-хлороацетамідів під дією амонію тіоціанату в середовищі ацетону синтезовано серію нових похідних 2-імінотіазолідин-4-ону. Наявність метиленактивної групи в положенні 5 тіазолідинового циклу отриманих 2-(1,3,4-тіадіазол-2-іл)імінотіазолідин-4-онів дозволила провести їх подальшу модифікацію в умовах реакції Кньовенагеля з різноманітними арил(гетерил)карбальдегідами, ізатином або похідними коричного альдегіду з утворенням серій відповідних 5-арил(гетерил)іліден- та 5-ізатин(3-фенілпропен)іліденпохідних як потенційних антитрипаносомних агентів. Структуру синтезованих сполук підтверджено елементним аналізом та спектроскопією ПМР.Висновки. Результати скринінгу антитрипаносомної активності in vitro синтезованих сполук на штамі Trypanosoma brucei gambiense (TBG) дозволили ідентифікувати чотири високоактивні сполуки, які зі значеннями IC50 в межах 7,3-12,8 мкМ володіли суттєвим трипаноцидним ефектом

Halogen chemistry in volcanic plumes: a 1D framework based on MOCAGE 1D (version R1.18.1) preparing 3D global chemistry modelling

HBr emissions from volcanoes lead rapidly to the formation of BrO within volcanic plumes and have an impact on tropospheric chemistry, at least at the local and regional scales. The motivation of this paper is to prepare a framework for further 3D modelling of volcanic halogen emissions in order to determine their fate within the volcanic plume and then in the atmosphere at the regional and global scales. The main aim is to evaluate the ability of the model to produce a realistic partitioning of bromine species within a grid box size typical of MOCAGE (Model Of atmospheric Chemistry At larGE scale) 3D (0.5×0.5). This work is based on a 1D single-column configuration of the global chemistry-transport model MOCAGE that has low enough computational cost to allow us to perform a large set of sensitivity simulations. This paper uses the emissions from the Mount Etna eruption on 10 May 2008. Several reactions are added to MOCAGE to represent the volcanic plume halogen chemistry. A simple plume parameterisation is also implemented and tested. The use of this parameterisation tends to only slightly limit the efficiency of BrO net production. Both simulations with and without the parameterisation give results for the partitioning of the bromine species, of ozone depletion and of the BrO/SO2 ratio that are consistent with previous studies. A series of test experiments were performed to evaluate the sensitivity of the results to the composition of the emissions (primary sulfate aerosols, Br radical and NO) and to the effective radius assumed for the volcanic sulfate aerosols. Simulations show that the plume chemistry is sensitive to all these parameters. We also find that the maximum altitude of the eruption changes the BrO production, which is linked to the vertical variability of the concentrations of oxidants in the background air. These sensitivity tests display changes in the bromine chemistry cycles that are generally at least as important as the plume parameterisation. Overall, the version of the MOCAGE chemistry developed for this study is suitable to produce the expected halogen chemistry in volcanic plumes during daytime and night-time

Chlorination Disinfection By-Products in Drinking Water and Congenital Anomalies: Review and Meta-Analyses

This study aims to review epidemiologic evidence of the association between exposure to chlorination disinfection by-products (DBPs) and congenital anomalies. All epidemiologic studies that evaluated a relationship between an index of DBP exposure and risk of congenital anomalies were analyzed. For all congenital anomalies combined, the meta-analysis gave a statistically significant excess risk for high versus low exposure to water chlorination or TTHM (17%; 95% CI, 3-34) based on a small number of studies. The meta-analysis also suggested a statistically significant excess risk for ventricular septal defects (58%; 95% CI, 21-107), but based on only three studies, and there was little evidence of an exposure-response relationship. It was observed no statistically significant relationships in the other meta-analyses and little evidence for publication bias, except for urinary tract defects and cleft lip and palate. Although some individual studies have suggested an association between chlorination disinfection by-products and congenital anomalies, meta-analyses of all currently available studies demonstrate little evidence of such association

Research note: residential distance and recreational visits to coastal and inland blue spaces in eighteen countries

Varied categorisations of residential distance to bluespace in population health studies make comparisons difficult. Using survey data from eighteen countries, we modelled relationships between residential distance to blue spaces (coasts, lakes, and rivers), and self-reported recreational visits to these environments at least weekly, with penalised regression splines. We observed exponential declines in visit probability with increasing distance to all three environments and demonstrated the utility of derived categorisations. These categories may be broadly applicable in future research where the assumed underlying mechanism between residential distance to a blue space and a health outcome is direct recreational contact.info:eu-repo/semantics/publishedVersio

Environmental risk factors of pregnancy outcomes: A summary of recent meta-analyses of epidemiological studies.

Background Various epidemiological studies have suggested associations between environmental exposures and pregnancy outcomes. Some studies have tempted to combine information from various epidemiological studies using meta-analysis. We aimed to describe the methodologies used in these recent meta-analyses of environmental exposures and pregnancy outcomes. Furthermore, we aimed to report their main findings. Methods We conducted a bibliographic search with relevant search terms. We obtained and evaluated 16 recent meta-analyses. Results The number of studies included in each reported meta-analysis varied greatly, with the largest number of studies available for environmental tobacco smoke. Only a small number of the studies reported having followed meta-analysis guidelines or having used a quality rating system. Generally they tested for heterogeneity and publication bias. Publication bias did not occur frequently. The meta-analyses found statistically significant negative associations between environmental tobacco smoke and stillbirth, birth weight and any congenital anomalies; PM2.5 and preterm birth; outdoor air pollution and some congenital anomalies; indoor air pollution from solid fuel use and stillbirth and birth weight; polychlorinated biphenyls (PCB) exposure and birth weight; disinfection by-products in water and stillbirth, small for gestational age and some congenital anomalies; occupational exposure to pesticides and solvents and some congenital anomalies; and agent orange and some congenital anomalies. Conclusions The number of meta-analyses of environmental exposures and pregnancy outcomes is small and they vary in methodology. They reported statistically significant associations between environmental exposures such as environmental tobacco smoke, air pollution and chemicals and pregnancy outcomes

Plasmodium falciparum proteinases: cloning of the putative gene coding for the merozoite proteinase for erythrocyte invasion (MPEI) and determination of hydrolysis sites of spectrin by Pf37 proteinase

Numerous proteinase activities have been shown to be essential for the survival of Plasmodium falciparum. One approach to antimalarial chemotherapy, would be to block specifically one or several of these activities, by using compounds structurally analogous to the substrates of these proteinases. Such a strategy requires a detailed knowledge of the active site of the proteinase, in order to identify the best substrate for the proteinase. Aiming at developing such a strategy, two proteinases previously identified in our laboratory, were chosen for further characterization of their molecular structure and properties: the merozoite proteinase for erythrocytic invasion (MPEI), involved in the erythrocyte invasion by the merozoites, and the Pf37 proteinase, which hydrolyses human spectrin in vitro

Perspectives on the Trypanosoma cruzi-host cell receptor interaction

Chagas disease is caused by the parasite Trypanosoma cruzi. The critical initial event is the interaction of the trypomastigote form of the parasite with host receptors. This review highlights recent observations concerning these interactions. Some of the key receptors considered are those for thromboxane, bradykinin, and for the nerve growth factor TrKA. Other important receptors such as galectin-3, thrombospondin, and laminin are also discussed. Investigation into the molecular biology and cell biology of host receptors for T. cruzi may provide novel therapeutic targets