Revisiting the Wilson-Jungner criteria: how can supplemental criteria guide public health in the era of genetic screening?

Purpose Advances in technology have made newborn screening (NBS) for more than fifty inborn errors of metabolism possible using a dried blood sample. A framework is proposed that public health practitioners may use when considering candidate disorders for NBS panels. Methods The framework expands upon the ten Wilson-Jungner criteria with the addition of eleven criteria specific to NBS. A calculation, the “pNBS Decision Score”, is used to quantify results and rank candidate disorders. Results The pNBS Decision Scores that were calculated for Phenylketonuria (OMIM 261600), Cystic Fibrosis (OMIM 219700), Pompe Disease (OMIM 232300) and Severe Combined Immunodeficiency (OMIM 102700) support their inclusion as NBS disorders. The pNBS Decision Score suggests that Krabbe Disease (OMIM 245200) is not a candidate disorder for inclusion at this time. Conclusion The proposed framework adds to the ability of policy-makers to quantify an essential portion of the process for adding disorders to newborn screening panels. Other factors such as ethical, legal and social issues, clinical utility and advocacy are also part of the policy process. The framework is not intended to replace existing nomination processes, but rather to enhance those processes by encouraging iterative review of NBS-specific criteria. The use of the framework will provide consistency across a portion of the decision process. The public health community should take the opportunity to re-visit the screening determinants of the Wilson-Jungner criteria from a twenty-first century perspective. The results suggest that this framework provides the public health practitioner with a consistent process for making an evidence-based decision

Drought inhibits early seedling establishment of Parkinsonia aculeata L. under low light intensity: a physiological approach

Seedling growth of the invasive weed Parkinsonia aculeata L. may occur during water shortage under dense canopy at low light intensity. Experiments performed under controlled conditions during 22 days showed that water stress inhibited growth and decreased water, osmotic and turgor potentials. Drought conditions reduced stomatal conductance and net photosynthesis but had no obvious impact on chlorophyll fluorescence or chlorophyll content. Maximum photochemical efficiency of PSII (Fv/Fm) was affected only after 22 days of stress. Despite the low light intensity, a precocious activation of the xanthophyll cycle allowed an efficient protection of PSII through non-radiative energy dissipation and a significant decrease of epoxidation state was observed already after 11 days of treatment. Water stress reduced photosynthesis mainly through stomatal closure but increased water use efficiency. Active osmotic adjustment was a late process observed after 15 days of treatment and proline over synthesis may account for it while sugar accumulation appeared as a consequence of growth inhibition. Malondialdehyde did not accumulate in stressed plants after day 11, suggesting a limited oxidative stress. However, a putative involvement of phenolic compounds in the management of stress-induced oxygen reactive species is hypothesized. Young seedlings of P. aculeata exposed to water stress in semi-arid areas under low light intensity may, to some extent, adopt physiological strategies allowing them to survive and contribute to the invader potential of this species. © 2016 Springer Science+Business Media Dordrech