European Recommendations for Primary Prevention of Congenital Anomalies: A Joined Effort of EUROCAT and EUROPLAN Projects to Facilitate Inclusion of This Topic in the National Rare Disease Plans

Congenital anomalies (CA) are the paradigm example of rare diseases liable to primary prevention actions due to the multifactorial etiology of many of them, involving a number of environmental factors together with genetic predispositions. Yet despite the preventive potential, lack of attention to an integrated preventive strategy has led to the prevalence of CA remaining relatively stable in recent decades. The 2 European projects, EUROCAT and EUROPLAN, have joined efforts to provide the first science-based and comprehensive set of recommendations for the primary prevention of CA in the European Union. The resulting EUROCAT-EUROPLAN \u27Recommendations on Policies to Be Considered for the Primary Prevention of Congenital Anomalies in National Plans and Strategies on Rare Diseases\u27 were issued in 2012 and endorsed by EUCERD (European Union Committee of Experts on Rare Diseases) in 2013. The recommendations exploit interdisciplinary expertise encompassing drugs, diet, lifestyles, maternal health status, and the environment. The recommendations include evidence-based actions aimed at reducing risk factors and at increasing protective factors and behaviors at both individual and population level. Moreover, consideration is given to topics specifically related to CA (e.g. folate status, teratogens) as well as of broad public health impact (e.g. obesity, smoking) which call for specific attention to their relevance in the pre- and periconceptional period. The recommendations, reported entirely in this paper, are a comprehensive tool to implement primary prevention into national policies on rare diseases in Europe

Energy Balance Closure At Fluxnet Sites

A comprehensive evaluation of energy balance closure is performed across 22 sites and 50 site-years in FLUXNET, a network of eddy covariance sites measuring long-term carbon and energy fluxes in contrasting ecosystems and climates. Energy balance closure was evaluated by statistical regression of turbulent energy fluxes (sensible and latent heat (LE)) against available energy (net radiation, less the energy stored) and by solving for the energy balance ratio, the ratio of turbulent energy fluxes to available energy. These methods indicate a general lack of closure at most sites, with amean imbalance in the order of 20%. The imbalance was prevalent in all measured vegetation types and in climates ranging from Mediterranean to temperate and arctic. There were no clear differences between sites using open and closed path infrared gas analyzers. At a majority of sites closure improved with turbulent intensity (friction velocity), but lack of total closure was still prevalent under most conditions. The imbalance was greatest during nocturnal periods. The results suggest that estimates of the scalar turbulent fluxes of sensible and LE are underestimated and/or that available energy is overestimated. The implications on interpreting long-term CO2 fluxes at FLUXNET sites depends on whether the imbalance results primarily from general errors associated with the eddy covariance technique or from errors in calculating the available energy terms. Although it was not entirely possible to critically evaluate all the possible sources of the imbalance, circumstantial evidence suggested a link between the imbalance and CO2 fluxes. For a given value of photosynthetically active radiation, the magnitude of CO2 uptake was less when the energy imbalance was greater. Similarly, respiration (estimated by nocturnal CO2 release to the atmosphere) was significantly less when the energy imbalance was greater