Circadian changes and sex-related differences in fetal heart rate parameters

BACKGROUND: Previous researchers have studied circadian changes in the fetal heart rate (FHR) on small sample sizes and in a strictly controlled environment. This study was undertaken to investigate these changes during the late second and third trimesters, using a portable fetal electrocardiogram recording device (Monica AN24) in pregnant women in home and hospital environments with unrestricted mobility. METHODS: This was a prospective cohort study of 54 pregnant women with uncomplicated singleton pregnancies between 25 and 40 weeks gestation. FHR recordings were made up to 16 h at home or in the hospital setting in the United Kingdom. FHR data over 90 min periods were averaged and the day (7:00 am-11:00 pm) and night (11:00 pm-7:00 am) data from the same individual were compared. Data were examined for evidence of sex-related differences. RESULTS: During the night, there was a significant reduction in basal heart rate (bFHR) and a significant increase in short term variation (STV) and long term variation (LTV) (P < 0.05). Basal FHR decreased (P < 0.002), whereas LTV increased (P = 0.014) with advancing gestation. Male fetuses showed greater day: night variation than females regardless of gestation (P = 0.014). There was a higher bFHR in fetuses monitored during the day in hospital (P = 0.04). CONCLUSION: This study demonstrates that there are sex-, environment and time-related differences in the FHR parameters measured. These differences may need to be considered taken when interpreting FHR data

Bioaccessibility of selenium after human ingestion in relation to its chemical species and compartmentalization in maize

International audienceSelenium is a micronutrient needed by all living organisms including humans, but often present in low concentration in food with possible deficiency. From another side, at higher concentrations in soils as observed in seleniferous regions of the world, and in function of its chemical species, Se can also induce (eco)toxicity. Root Se uptake was therefore studied in function of its initial form for maize (Zea mays L.), a plant widely cultivated for human and animal food over the world. Se phytotoxicity and compartmentalization were studied in different aerial plant tissues. For the first time, Se oral human bioaccessibility after ingestion was assessed for the main Se species (SeIV and SeVI) with the BARGE ex vivo test in maize seeds (consumed by humans), and in stems and leaves consumed by animals. Corn seedlings were cultivated in hydroponic conditions supplemented with 1 mg L−1 of selenium (SeIV, SeVI, Control) for 4 months. Biomass, Se concentration, and bioaccessibility were measured on harvested plants. A reduction in plant biomass was observed under Se treatments compared to control, suggesting its phytotoxicity. This plant biomass reduction was higher for selenite species than selenate, and seed was the main affected compartment compared to control. Selenium compartmentalization study showed that for selenate species, a preferential accumulation was observed in leaves, whereas selenite translocation was very limited toward maize aerial parts, except in the seeds where selenite concentrations are generally high. Selenium oral bioaccessibility after ingestion fluctuated from 49 to 89 % according to the considered plant tissue and Se species. Whatever the tissue, selenate appeared as the most human bioaccessible form. A potential Se toxicity was highlighted for people living in seleniferous regions, this risk being enhanced by the high Se bioaccessibility

Health care provider and patient preparedness for alternative colorectal cancer follow-up; a review

Follow-up after curative treatment for colorectal cancer (CRC) puts pressure on outpatient services due to the growing number of CRC survivors. The aim of this state-of-the-art review was to evaluate setting, manner and provider of follow-up. Moreover, perceptions of CRC survivors and health care providers regarding standard and alternative follow-up were examined. After a comprehensive literature search of the PubMed database, 69 articles were included reporting on CRC follow-up in the hospital, primary care and home setting. Hospital-based follow-up is most common and has been provided by surgeons, medical oncologists, and gastroenterologists, as well as nurses. Primary care-based follow-up has been provided by general practitioners or nurses. Even though most hospital- or primary care-based follow-up care requires patients to visit the clinic, telephone-based care has proven to be a feasible alternative. Most patients perceived follow-up as positive; valuing screening and detection for disease recurrence and appreciating support for physical and psychosocial symptoms. Hospital-based follow-up performed by the medical specialist or nurse is highly preferred by patients and health care providers. However, willingness of both patients and health care providers for alternative, primary care or remote follow-up exists. Nurse-led and GP-led follow-up have proven to be cost-effective alternatives compared to specialist-led follow-up. If proven safe and acceptable, remote follow-up can become a cost-effective alternative. To decrease the personal and financial burden of follow-up for a growing number of colorectal cancer survivors, a more acceptable, flexible and dynamic care follow-up mode consisting of enhanced communication and role definitions among clinicians is warranted

Voortgangsrapportage project Saneringscriterium. januari - juli 2007

In dit briefrapport wordt een overzicht gegeven van de werkzaamheden uitgevoerd in de periode januari-juli 2007 voor het project Saneringscriterium. In de eerste helft van 2007 heeft het RIVM gewerkt heeft aan de implementatie van de besluiten van het project Normstelling Bodemkwaliteit in Sanscrit. Sanscrit wordt in het milieuhygienisch saneringscriterium aangewezen als instrument voor de beoordeling van ernstig verontreinigde locaties. Deze werkzaamheden zijn in overleg met de Projectbegeleider van VROM uitgevoerd. In de tweede helft van 2007 worden de activiteiten voortgezet.VROM-LMV-SB

[Validatie van het model PESTLA: Definities, doelstellingen en procedure.]

The simulation model PESTLA was developed to produce estimates of accumulation and leaching of pesticides in soil to facilitate classification of pesticides in the Dutch registration procedure. Before PESTLA can be used for quantitative assessment of expected pesticide concentrations in groundwater, its accuracy to predict field-scale pesticide leaching needs to be assessed. The project "Validation of PESTLA" aims at evaluation of the applicability of PESTLA for the current assessment procedure for pesticide registration in the Netherlands. The present report is the first in a series of reports and provides a short overview of the history of PESTLA. The objectives of the project are outlined, and some background information on the process of model development is given. The specific tasks of the project are defined in this context. A list of definitions of the terms used during the project is included. Several methods are described with which model predictions can be compared with (field) measurements of pesticide leaching. This is preceded by a discussion on statistical hypotheses, which is needed to understand the Chapters that follow. The so-called factor-of-f approach is selected as the tool to be used in the evaluation of PESTLA performance. The factor-of-f approach acknowledges that both model predictions and field measurements usually cover a range of possible values instead of one fixed value. This implies that comparison of the two must be done by statistical methods. The factor-of-f approach allows uncertainty of a size f around the predicted value. It concludes the model to be 'acceptable' when a range of measured values fall within the range of model predictions as defined by the size of the factor f. Finally, the overall approach of the project is outlined in terms of several selected activities that intend to lead to validation of PESTLA.LNV/DG - Landelijke Gebieden en Kwaliteitszorg- Directie GewasbeschermingDGM/DW