Early in pregnancy women and their partners face the complex decision on whether or not to participate in prenatal testing for fetal chromosomal abnormalities. Several studies show that the majority of pregnant women currently do not make informed decisions regarding prenatal testing. As the range of prenatal tests is expanding due to the development of new techniques such as non-invasive prenatal testing (NIPT), autonomous reproductive decision-making is increasingly challenging. In this study, a randomised controlled trial was conducted to evaluate the effect of a web-based multimedia decision aid on decision-making regarding prenatal testing. The decision aid provided both written and audiovisual information on prenatal tests currently available, that is, prenatal screening by first-trimester combined testing, NIPT and invasive diagnostic testing through chorionic villus sampling or amniocentesis. Furthermore, it contained values clarification exercises encouraging pregnant women to reflect on the potential harms and benefits of having prenatal tests performed. The use of the decision aid improved informed decisionmaking regarding prenatal testing. Of pregnant women allocated to the intervention group (n = 130) 82.3% made an informed choice compared with 66.4% of women in the control group (n = 131), P = 0.004. As the vast majority of pregnant women made decisions consistent with their attitudes towards having prenatal testing performed, this improvement in informed decisionmaking could be attributed mainly to an increase in decision-relevant knowledge. This study shows that the implementation of a web-based multimedia decision aid directly facilitates the ultimate goal of prenatal testing for fetal chromosomal abnormalities, which is enabling informed autonomous reproductive choice. European Journal of Human Genetics (2016) 24, 1409-1416; doi:10.1038/ejhg.2016.39; published online 18 May 2016 INTRODUCTIONThe main purpose of prenatal testing for fetal chromosomal abnormalities is facilitating autonomous reproductive decision-making for pregnant women and their partners, rather than achieving high uptake rates or prevention of children with chromosomal abnormalities being born. 1,2 In order to achieve autonomous reproductive decisionmaking, the choice to accept or decline prenatal testing should be informed. An informed choice is made when a woman has adequate decision-relevant knowledge and when her participation or nonparticipation is consistent with her values and attitudes towards undergoing prenatal testing. 3,4 It requires healthcare professionals to provide accurate, comprehensive and neutral information about the options available. Subsequently, the pregnant woman has to be encouraged to integrate this knowledge with her personal values when reflecting on the possible implications of having prenatal testing performed. Most international evaluations show that the majority of pregnant women currently do not make informed decisions regarding prenatal testing. 5,6 With the development and introduction of n...

This paper describes the development of an end-to-end quality measurement method that allows us to quantify the perceived quality of Interactive Gaming, with an emphasis on the so-called First Person Shooter (FPS) game Quake IV. We conducted a number of subjective experiments to quantify the impact of network parameters on the perceived quality of this recent FPS game. Making use of a multi-dimensional regression analysis we developed the Quake IV G-model which enables us to predict a gamer's Quake IV quality rating (expressed in a Mean Opinion Score) based on measured ping and jitter values. Our G-model shows a very high correlation (R = 0.98) with the subjective data.

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Our results show that plasma placenta growth factor levels are decreased before preeclampsia is clinically evident. The data suggest that placenta growth factor may be useful to determine the relative risk of developing preeclampsia and intrauterine growth restriction.

To study central nervous system development, 18 normally developing embryos or fetuses were examined sonograf,hicaiiy between 6 and 16 weeks of pregnancy. Furt termore, in a 5 year period, 693 fetuses with an elevated risk for congenital defects were examined before 16 weeks of gestation. Abnormal development of the central nervous sys· tern was found in 28 fetuses. Early in pregnancy, normal central nervous system formation can be T ransvaginal ultrasonography in the first trimester of pregnancy permits excellent visualization of fetal organs and tissues.J Next to the expertise of the examiners and the availability of high-resolution ultrasonographic equipment, knowledge of normal embryologic development and its corresponding ultrasonographic images is essential for a proper evaluation of pathologic development early in pregnancy. Early diagnosis of several congenital anomalies is currently possible and patients with an elevated recurrence risk can be offered an extensive ultrasonographic examination early in pregnancy for the exclusion or detection of fetal malformations.Ultrasonographic studies of normal first trimester formation of the embryonic cerebrum have been reported.l-4 The number of early detectable malfor· mations of the central nervous system has increased recognized, and lathologic cerebral development can be diagnose already in the first trimester of pregnancy. We recommend routine use of safe and noninvasive transvaginal ultrasonography early in pregnancy for patients at risk. KEY WORDS: Transvaginal ultrasonography; Central nervous system; Embryo; Abnormal development; First trimester.in recent years. Rottem and coworkers were among the first authors to describe the detection of anen· cephaly with transvaginal ultrasonography in the first trimester of pregnancy.5..6 After the publication of these initial reports many other malformations of the fetal central nervous system have been detected early in pregnancy and have been reported, such as exencephaly, cephalocele, Dandy-Walker malformation, and holoprosencephaly.7·11The aim of the current study was to visualize normal in vivo embryonic cerebral development using transvaginal sonography and to exclude or detect abnormal central nervous system formation in the first and early second trimester of pregnancy in a group of patients with an elevated recurrence risk of fetal defects. PATIENTS AND METHODSTo study normal central nervous system development, 18 singleton pregnancies were examined weekly between 6 and 16 weeks' menstrual age. The women were examined 8 to 11 times. A total of 173 0 1995 by the American Institute of Ultrasound in Medicine • J Ultrasound Med 14: 603-610, 1995 • 0278-4297/95/$3.50