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Khoshnood B.,French Institute of Health and Medical Research | Khoshnood B.,University Pierre and Marie Curie | Loane M.,University of Ulster | Garne E.,Hospital Lillebaelt | And 25 more authors.
Journal of Pediatrics | Year: 2013

Objectives: To examine trends in the prevalence of congenital heart defects (CHDs) in Europe and to compare these trends with the recent decrease in the prevalence of CHDs in Canada (Quebec) that was attributed to the policy of mandatory folic acid fortification. Study design: We used data for the period 1990-2007 for 47 508 cases of CHD not associated with a chromosomal anomaly from 29 population-based European Surveillance of Congenital Anomalies registries in 16 countries covering 7.3 million births. We estimated trends for all CHDs combined and separately for 3 severity groups using random-effects Poisson regression models with splines. Results: We found that the total prevalence of CHDs increased during the 1990s and the early 2000s until 2004 and decreased thereafter. We found essentially no trend in total prevalence of the most severe group (group I), whereas the prevalence of severity group II increased until about 2000 and decreased thereafter. Trends for severity group III (the most prevalent group) paralleled those for all CHDs combined. Conclusions: The prevalence of CHDs decreased in recent years in Europe in the absence of a policy for mandatory folic acid fortification. One possible explanation for this decrease may be an as-yet-undocumented increase in folic acid intake of women in Europe following recommendations for folic acid supplementation and/or voluntary fortification. However, alternative hypotheses, including reductions in risk factors of CHDs (eg, maternal smoking) and improved management of maternal chronic health conditions (eg, diabetes), must also be considered for explaining the observed decrease in the prevalence of CHDs in Europe or elsewhere. Copyright © 2013 Mosby Inc.

De Souza E.,Queen Mary, University of London | Morris J.K.,Queen Mary, University of London | Dolk H.,EUROCAT Central Registry | Bianca S.,ISMAC
Archives of Disease in Childhood | Year: 2010

Objectives: To determine whether older paternal age increases the risk of fathering a pregnancy with Patau (trisomy 13), Edwards (trisomy 18), Klinefelter (XXY) or XYY syndrome. Design: Case-control: cases with each of these syndromes were matched to four controls with Down syndrome from within the same congenital anomaly register and with maternal age within 6 months. Setting: Data from 22 EUROCAT congenital anomaly registers in 12 European countries. Participants: Diagnoses with observed or (for terminations) predicted year of birth from 1980 to 2005, comprising live births, fetal deaths with gestational age ≥20 weeks and terminations after prenatal diagnosis of the anomaly. Data include 374 cases of Patau syndrome, 929 of Edwards syndrome, 295 of Klinefelter syndrome, 28 of XYY syndrome and 5627 controls with Down syndrome. Main outcome measures: Odds ratio (OR) associated with a 10-year increase in paternal age for each anomaly was estimated using conditional logistic regression. Results were adjusted to take account of the estimated association of paternal age with Down syndrome (1.11; 95% CI 1.01 to 1.23). Results: The OR for Patau syndrome was 1.10 (95% CI 0.83 to 1.45); for Edwards syndrome, 1.15 (0.96 to 1.38); for Klinefelter syndrome, 1.35 (1.02 to 1.79); and for XYY syndrome, 1.99 (0.75 to 5.26). Conclusions: There was a statistically significant increase in the odds of Klinefelter syndrome with increasing paternal age. The larger positive associations of Klinefelter and XYY syndromes with paternal age compared with Patau and Edwards syndromes are consistent with the greater percentage of these sex chromosome anomalies being of paternal origin.

Losio S.,ISMAC | Leone G.,ISMAC | Bertini F.,ISMAC | Ricci G.,ISMAC | And 2 more authors.
Polymer Chemistry | Year: 2014

Ethylene (E) and 4-methyl-1-pentene (4M1P) are copolymerized using an α-diimine Ni(ii) catalyst with MAO (methylaluminoxane) or Et 2AlCl (diethylaluminium chloride) as the cocatalyst. A series of copolymers with a 4M1P comonomer content ranging from 0.94 to 36.73 mol% are obtained. A detailed 13C NMR assignment is presented and this thorough analysis has opened up the first full description of this interesting family of copolymers. Manifold branched copolymers are obtained with no noticeable differences in the branching distribution by using MAO or Et 2AlCl. The resonance assignments are correlated with the chain-walking mechanism: branching analysis shows that the total amount of 2,1 insertion of the comonomer, followed by backward migration of the nickel active species along the polymer chain, is higher than that of 1,2 inserted 4M1P. This journal is © The Royal Society of Chemistry.

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