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Study Objective: To evaluate recurrence rate and pattern in apparently early-stage endometrial cancer (EC) treated with minimally invasive surgery (MIS) and compare it to the “historical” populations treated by laparotomy. Secondary outcomes were to establish if, among MIS recurrent patients, intermediate-high/high-risk patients presented the same recurrence pattern compared to those at low/intermediate-risk and to evaluate time to first recurrence (TTR) of the study population. Design: Multicenter retrospective observational study. Setting: Five Italian Gynecologic Oncology referral centers. Patients: All patients with proven recurrence of apparently early-stage EC treated with MIS from January 2017 to June 2022 . The laparotomic historical cohort was obtained from Laparoscopy Compared With Laparotomy for Comprehensive Surgical Staging of Uterine Cancer: Gynecologic Oncology Group Study (LAP2) and Laparoscopic Approach to Cancer of the Endometrium trials. Interventions: Evaluation of recurrence rate and pattern. Measurements and Main Results: Seventy-seven recurrences occurred on the total of 1028 patients treated with MIS for apparently early-stage EC during a median follow-up time of 36 months. The rate of recurrence in our cohort did not differ significantly from the rate of the historical cohort (7.4% vs 7.9%, odds ratio 0.9395, 95% CI 0.6901–1.2792). No significant differences were noticed for local, abdominal, nodal, and multiple site recurrence patterns; distant site recurrence appeared more likely in patients from the historical cohort. Postoperative low/intermediate risk patients had a higher likelihood of local recurrence compared to intermediate-high/high risk patients. Mean TTR was 19 months. No significant difference of TTR was observed for each pattern of recurrence compared to others. Conclusion: MIS appears to be safe for the treatment of early-stage EC. We did not identify any recurrence pattern specifically associated with MIS in early-stage EC.

The article discusses the use of tritium (H-3) and cesium (Cs-137) as temporal markers in ice cores extracted from temperate glaciers. We present a complete tritium profile for a 46 m ice core drilled from the Adamello Glacier, a temperate glacier in the Italian Alps, and compare it to the Cs-137 profile from the same ice core. Our analysis reveals tritium contamination between 19 and 32 m of depth, which can be attributed to the global radioactive fallout caused by atmospheric nuclear-bomb testing that took place in the 1950s and 1960s. Results show that the radioactive peak associated with 1963 does not occur at the same depth for both H-3 and Cs-137; instead, the tritium peak is 1.5 m above the cesium one. Our hypothesis is that this misalignment is caused by meltwater-induced post-depositional processes that affect Cs-137, which is more sensitive to percolation than H-3. The total inventory of Cs-137 in this ice core is also among the lowest ever reported, providing additional evidence that the presence of meltwater has affected the distribution of this radionuclide within the ice. In contrast, the total tritium inventory is comparable to what is reported in the literature, making it a more reliable temporal marker for temperate glaciers.

Paleoclimate and paleoenvironmental stratigraphic reconstructions from temperate glaciers are hindered by surface melting and ice metamorphism, which cause mobilization and concentration of impurities, as well as their interaction through englacial reactions. Despite meltwater intrusions, other impurities such as pollen grains and other palynomorphs remain to their original depth of deposition thanks to their large grain size. Temperate glaciers close to vegetated areas, therefore, can include palynomorphs of different types that i) can be reliable annual markers for ice-core dating and, ii) allow reconstructing paleoenvironmental changes through time. The Adamello Glacier (Central Alps, Italy) is a temperate glacier that extends over ca 14.35 km2 (2020) at elevations ranging between 2560 and 3420 m a.s.l. In the framework of the CLIMADA Project, a 224 m long ice core (ADA 270) was recovered in 2021 from Pian di Neve, the summit plateau at about 3200 m a.s.l. in the accumulation area of the glacier. Preliminary estimates date the surface ice of the glacier to the 1980s while the bottom of the core might be Medieval in age. Radionuclide-based dating (3H, 14C, 137Cs, 210Pb) is in progress. The multiproxy approach adopted in this study includes black carbon, dust grain size and mineralogy, oxygen and hydrogen stable isotopes and palynomorphs, these last being the main object of this work. Given the site location, the palaeoecological signal is believed to be of regional significance. Despite the stratigraphy may not be preserved for some soluble chemical species, the core contains a high variety of palynomorphs, which allow the reconstruction of palaeoenvironmental and paleoclimatic variations at subannual resolution. The mean ice accumulation rate is about 0.9 m w.eq. yr-1. Consequently, the mean sampling resolution adopted for the palynomorph study is 0.1 m, increased to 0.01 m in specific intervals. Palynomorphs are mainly found in layers representing the spring-sum

Paleoclimatic information recorded in polar and mountain glaciers are very important to study climate and environmental changes, telling a story about the ancient past and the ongoing cryosphere response to the anthropogenic impact. In this contest, a new high spatial resolution ice-core analysis has been done using a hyperspectral system, which allows to detect ice characteristics related to paleoclimatic information in a new non destructive way. This improves the accuracy of measurements and the preservation of samples. The hyperspectral analysis has been applied on sections from the ADA270 ice core project, drilled in 2021 at the Adamello-Mandrone glacial group (Pian di Neve, Eastern Alps, Italy). The optical method acquires reflectance images collecting spectral radiance in 840 bands in visible and NIR wavelengths (400-1000 nm). Different optical descriptors have been computed from all reflectance spectra to measure variations due to ice features and impurities encloses in ice layers. In particular, we considered the surface albedo and two spectral indices: Snow Darkening Index (SDI) and Impurity Index (II). From such descriptors continuous records along the core, in particular Albedo and SDI, samples are accurately selected and melted to make a discrete analysis with a Coulter Counter Beckman Multisizer 4e to make a calibration. Analyzed features are ice lenses, visible air bubbles, medium supposed dust concentration and high content of visible materials. The discrete data have been matched with SDI values for all analyzed sections to apply a regression model. A calibrated curve for impurities concentration has been created, providing a very important tool to not systematically apply destructive measurements in all ice-core sections. For a depth ranging from 14 m to around 35 m, many high concentration peaks (to a maximum of 30-35 ppm) have been identified and associated to visible impurities layers. The rest of the curve, highlights concentrations lower than 5

Le superfici ghiacciate del pianeta sono un archivio privilegiato di informazioni sulla storia climatica della Terra. La loro capacità di riflettere la radiazione solare (definita Albedo) è fortemente influenzata dalla deposizione di polveri minerali provenienti da diverse sorgenti, con un conseguente impatto sul budget energetico del pianeta e sulla qualità del segnale preservato nel ghiaccio. Le polveri minerali (dette dust), una volta depositate sui ghiacciai, causano l’assorbimento di maggiori porzioni della radiazione solare incidente in funzione della concentrazione, della composizione mineralogica e delle dimensioni delle particelle che le compongono. Il ghiacciaio dell’Adamello, il più profondo ed esteso delle Alpi italiane, è stato scelto come sito del progtto di ricerca ClimADA, che mira a ricostruire la storia climatica dell’arco alpino negli ultimi anni. Dal ghiacciaio è stata estratta nell’aprile 2021, nell’ambito del progetto ClimADA, una carota di ghiaccio di 224m, trasportata per la conservazione e l’analisi presso l’EuroCold Lab. (Università Milano-Bicocca), un’infrastruttura di ricerca di importanza internazionale per lo studio delle carote di ghiaccio. Per estrarre le informazioni climatiche garantendo la preservazione dell’archivio di ghiaccio, è stato utilizzato lo strumento HyIce sviluppato all’interno del DISAT e che utilizza la tecnica iperspettrale per generare immagini ad alta risoluzione in modo non distruttivo, producendo alcuni descrittori ottici come Albedo, Snow Darkening Index (SDI) e Impurity Index. Questa tecnica è in grado di descrivere rispettivamente la radiazione luminosa riflessa, l’annerimento e la presenza di impurità sulle superfici composte da ghiaccio come i ghiacciai e le coperture nevose. Ogni immagine è costruita da una matrice di riflettanza, proprietà fisica che descrive la quantità di radiazione luminosa riflessa in relazione al fascio incidente. I record così estratti per l’intera carota di ghiaccio co

Ice-covered surfaces of the planet are a pristine glimpse on the climate history of the Earth. Their capability to reflect the solar radiation affects the energy budget through time, so that paleoclimatic information recorded in polar and mountain glaciers tell a story about climate and environmental changes. Climate variations are a glaring reality due to a progressive climate warming that has been observed since the 1950s. The latest 2022 IPCC report [1], highlights the worrying state of the entire cryosphere health. Mid-latitude glaciers, e.g., are highly sensitive to the current atmospheric warming, which is seriously compromising the quality of the signal preserved in the ice. Mineral dust aerosol in atmosphere can alter the Earth’s energy budget interacting with the solar electromagnetic radiation. The dust settled on glaciers surfaces varies the ice capability to reflect the incident radiation, so that a major portion of it is absorbed as a function of Light Absorbing Impurity (LAI) concentration, mineralogical composition, LAI shapes etc. Depending on formation sites different minerals have different optical properties, affecting cryosphere mechanisms in a way that has to be further investigated. Ice core studies from mid-latitude mountain glaciers are essential to infer recent climate variability and anthropogenic impact on a regional scale. In the scientific literature, various imaging non-destructive systems extract e.g. information from visual stratigraphy of ice cores [2]. Advanced techniques can further be developed to improve the accuracy of ice cores measurements, pursuing the preservation of such precious achieves. The aim of this work is to apply different approaches to improve the understanding and climate simulation models regarding ice optical properties and feedback mechanisms, focusing on mineral dust and ice internal features. First, a non destructive system based on a hyperspectral imaging sensor is used to analyze optical properties of ice

Mineral dust aerosol plays an important role in climate and biogeochemical processes by providing nutrients to marine and terrestrial ecosystems and by influencing the radiation balance of the atmosphere. In turn, mineral dust responds to natural and anthropogenic alterations of land cover and land use resulting from several environmental changes that occurred on different timescales. Contamination by aerosols is a very tangible threat to the cryosphere in the European Alps due to its proximity to highly urbanized areas, cultivated landscapes, and the largest hot desert in the world. We recently developed and assembled a continuous flow analysis system for studying the solid content of ice cores with a high time resolution, focusing on optical characterization methods based on light scattering. The line is designed to provide an integrated measurement of dust particles with Single-Particle Extinction and Scattering (SPES), digital holography, and an optical particle sizer (Abakus). Many of the particles found in ice are efficient scatterers and absorbers close to the size range of the visible light wavelength. We report some preliminary results from ice cores drilled during the ADA270 project, aiming at an in-depth characterization of the samples that provide essential information on the fast climate evolution, which is causing a severe degeneration of glaciers, among other consequences.

We reconstructed vegetation, fire and watershed history during the Late Roman-Early Middle Ages and in the last three centuries in a mixed conifer forest forming the middle mountain elevational belt in the inner Alpine region, analyzing co-registered micro-botanical data, charcoal particles, sediment lithology, nutrients, and modern pollen deposition from a high-resolution peat record in Valmalenco (Italian Alps). During Late Roman Age the site hosted a dump mixed conifer forest dominated by Picea abies and Abies alba on peaty forest soil, locally affected by fires which also triggered episodes of hillslope denudation. Fire frequency increases during Early Middle Ages dry and warm phases, favoring Alnus viridis and Larix, while Abies alba and Alnus glutinosa type maintained a main role in the pre- and post-fire. Specifically, Abies alba, nowadays eradicated from the Valmalenco watershed, withstood the local regime of low intensity surface fires for more than a millennium, from the Late Roman throughout the Early Middle Ages. Larix, Alnus viridis and Fraxinus excelsior abundance in modern vegetation is ascribed to effects of intensified disturbance in the Early Modern Age, and to further woodland thickening triggered by fire suppression and abandonment after the Second World War.

Thanks to its insolubility, mineral dust is considered a stable proxy in polar ice cores. With this study we show that the Talos Dome ice core (TALDICE, Ross Sea sector of East Antarctica) displays evident and progressive signs of post-depositional processes affecting the mineral dust record below 1000g m deep. We apply a suite of established and cutting-edge techniques to investigate the properties of dust in TALDICE, ranging from concentration and grain size to elemental composition and Fe mineralogy. Results show that through acidic/oxidative weathering, the conditions of deep ice at Talos Dome promote the dissolution of specific minerals and the englacial formation of others, affecting primitive dust features. The expulsion of acidic atmospheric species from ice grains and their concentration in localized environments is likely the main process responsible for englacial reactions. Deep ice can be seen as a "geochemical reactor"capable of fostering complex reactions which involve both soluble and insoluble impurities. Fe-bearing minerals can efficiently help in exploring such transformations.

Pollen data are widely used as proxies to reconstruct past vegetation and climate changes. During the last decades numerical techniques have been developed to quantitatively estimate climate parameters from fossil pollen assemblages. This contribution introduces first the concepts and methodologies based on modern calibration sets to obtain past climate reconstructions. Then, focusing on high-elevation environments, the use of elevational transects as a tool for the evaluation of pollen-climate models and a temperature reconstruction obtained from an alpine fossil site are presented.

A deeper understanding of past atmospheric circulation variability in the Central Andes is a high-priority topic in paleoclimatology mainly because of the necessity to validate climate models used to predict future precipitation trends and to develop mitigation and/or adaptation strategies for future climate change scenarios in this region.Within this context, we here investigate an 18-year firn core drilled at Nevado Illimani in order to interpret its mineral dust record in relation to seasonal processes, in particular atmospheric circulation and deep convection. The core was dated by annual layer counting based on seasonal oscillations of dust, calcium, and stable isotopes. Geochemical and mineralogical data show that dust is regionally sourced in winter and summer. During austral summer (wet season), an increase in the relative proportion of giant dust particles (20 um) is observed, in association with oscillations of stable isotope records (D, 18O). It seems that at Nevado Illimani both the deposition of dust and the isotopic signature of precipitation are influenced by atmospheric deep convection, which is also related to the total amount of precipitation in the area. This hypothesis is corroborated by regional meteorological data. The interpretation of giant particle and stable isotope records suggests that downdrafts due to convective activity promote turbulent conditions capable of suspending giant particles in the vicinity of Nevado Illimani. Giant particles and stable isotopes, when considered together, can be therefore used as a new proxy for obtaining information about deep convective activity in the past.

The FAMU experiment aims to measure for the first time the hyperfine splitting of the muonic hydrogen ground state. From this measurement the proton Zemach radius can be derived and this will shed light on the determination of the proton charge radius. In this paper, we describe the scientific goal, the method and the detailed preparatory work. This includes the outcome of preliminary measurements, subsequent refined simulations and the evaluation of the expected results. The experimental setup being built for the measurement of the hyperfine splitting to be performed at the RAL laboratory muon facility is also described.

We report the first measurement of the temperature dependence of muon transfer rate from muonic hydrogen atoms to oxygen between 100 and 300 K. Data were obtained from the X-ray spectra of delayed events in a gaseous target, made of a H2/O2 mixture, exposed to a muon beam. This work sets constraints on theoretical models of muon transfer and is of fundamental importance for the measurement of the hyperfine splitting of muonic hydrogen ground state as proposed by the FAMU collaboration.

In this paper, we provide a comprehensive overview of the state-of-knowledge of dust flux and variability in time and space in different sectors of East Antarctica during the Holocene. By integrating the literature data with new evidences, we discuss the dust flux and grain-size variability during the current interglacial and its provenance in the innermost part of the East Antarctic plateau as well as in peripheral regions located close to the Transantarctic Mountains. The local importance of aeolian mineral dust aerosol deflated from low-elevation areas of peripheral East Antarctica is also discussed in the light of new data from several coastal, low-elevation sites.

During the last glaciation the Eurasian continent was impacted by the global reorganization of atmospheric circulation caused by North Atlantic events, through changes in moisture storm tracks modulated by orography. Our research explores the linkages between climate evolution in the North Atlantic and in the Alps between 30.6 and 12.5 ka, This period, centered on the Last Glacial Maximum, experienced the most recent phase of maximum global ice volume, corresponding to a millennia-long phase of sea-level lowstand, minima in reconstructed sea surface temperatures and isotopic values from polar ice. We present a high-resolution multiproxy record from Lake Fimon at the southern Alpine foothills, where a larch forest-steppe persisted throughout the coldest spells. We analyse the fine climate structure of the MIS 3–2 transition, of the Alpine Last Glacial Maximum stepped by HS2, and provide an unprecedented fine resolution and accurate 14C dating of the Last Glacial Maximum and the early Alpine Lateglacial. We reconstructed quantitative climate parameters based on sensitive pollen descriptors, and derived co-registered sedimentary proxies for dust flux. Reconstructed series suggest that extreme continental spells in the Alps and cold boreal winters match the timing of Heinrich Stadials 2 and 1, episodes of iceberg discharge and release of rock fragments (Ice Rafted Debris) in the North Atlantic. The initiation of the LGM at 27.3 ka is marked by a 4 °C drop in July temperatures, likely responsible for the onset of glacial build-up in the Southern Alpine piedmont. The first extreme continental spell coincides with the British-Irish-sourced IRD event at 26.2 ka and with glacier retreat in the Southern Alps, persisting in the subsequent HS2. Late Glacial glacier collapse and extreme drought occurred during the first half of the HS1, 17.4–16.2 ka. The comparison of the results obtained at Lake Fimon with other terrestrial Eurasian records and with recalibrated marine chronolo

Objective: To evaluate the performance of third-trimester ultrasound for the diagnosis of clinically significant placenta accreta spectrum disorder (PAS) in women with low-lying placenta or placenta previa. Methods: This was a prospective multicenter study of pregnant women aged ≥ 18 years who were diagnosed with low-lying placenta (< 20 mm from the internal cervical os) or placenta previa (covering the internal cervical os) on ultrasound at ≥ 26 + 0 weeks' gestation, between October 2014 and January 2019. Ultrasound suspicion of PAS was raised in the presence of at least one of these signs on grayscale ultrasound: (1) obliteration of the hypoechogenic space between the uterus and the placenta; (2) interruption of the hyperechogenic interface between the uterine serosa and the bladder wall; (3) abnormal placental lacunae. Histopathological examinations were performed according to a predefined protocol, with pathologists blinded to the ultrasound findings. To assess the ability of ultrasound to detect clinically significant PAS, a composite outcome comprising the need for active management at delivery and histopathological confirmation of PAS was considered the reference standard. PAS was considered to be clinically significant if, in addition to histological confirmation, at least one of these procedures was carried out after delivery: use of hemostatic intrauterine balloon, compressive uterine suture, peripartum hysterectomy, uterine/hypogastric artery ligation or uterine artery embolization. The diagnostic performance of each ultrasound sign for clinically significant PAS was evaluated in all women and in the subgroup who had at least one previous Cesarean section and anterior placenta. Post-test probability was assessed using Fagan nomograms. Results: A total of 568 women underwent transabdominal and transvaginal ultrasound examinations during the study period. Of these, 95 delivered in local hospitals, and placental pathology according to the study protocol w

We report the first measurement of the temperature dependence of muon transfer rate from µp atoms to oxygen between 100 and 300 K. Data were obtained from the X-ray spectra of delayed events in gaseous target H2/O2 exposed to a muon beam. Based on the data, we determined the muon transfer energy dependence up to 0.1 eV, showing an 8-fold increase in contrast with the predictions of constant rate in the low energy limit. This work set constraints on theoretical models of muon transfer, and is of fundamental importance for the measurement of the hyperfine splitting of µp by the FAMU collaboration.

We describe an optical approach based on Digital Holography for single-particle characterization of mineral dust and micrometric particles, focusing on the analysis of airborne particles in meltwater from Antarctic ice cores. We record the holograms formed by the superposition of the transilluminating reference beam and the waves scattered by single particles. Taking a cue from recent approaches in the field and holography methods, we process the holograms to recover both optical and morphological properties of single dust grains. As a considerable advantage over traditional light-scattering-based methods, holograms give the extinction cross section of each particle and, by numerically reconstructing the wavefront propagation, an unambiguous image of each particle whereby we derive its cross-sectional shape and size. Measurements have been carried out on samples collected from the recent EAIIST (East Antarctic International Ice Sheet Traverse) project, some of which show evidence of volcanic events. The vast majority of the detected particles show significant deviations from the isometric shape, as confirmed by both image reconstruction and extinction cross section analysis. By our analysis, we observe that experimental data have an extinction cross section up to 3 times lower than that of spherical particles with the same volume. Therefore, these deviations have an appreciable impact on the aerosol contribution to radiative forcing: retrieving particle shape may improve the modeling of the radiative properties of mineral dust and reduce the associated uncertainties.

Current biodiversity loss is a major concern and thus biodiversity assessment of modern ecosystems is compelling and needs to be contextualized on a longer timescale. High Throughput Sequencing (HTS) is progressively becoming a major source of data on biodiversity time series. In this multi proxy study, we tested, for the first time, the potential of HTS to estimate plant biodiversity archived in the surface layers of a temperate alpine glacier, amplifying the trnL barcode for vascular plants from eDNA of firn samples. A 573 cm long core was drilled by the Adamello glacier and cut into sections; produced samples were analyzed for physical properties, stable isotope ratio, and plant biodiversity by eDNA metabarcoding and conventional light microscopy analysis. Results highlighted the presence of pollen and plant remains within the distinct layers of snow, firn and ice. While stable isotope ratio showed a scarcely informative pattern, DNA metabarcoding described distinct plant species composition among the different samples, with a broad taxonomic representation of the biodiversity of the catchment area and a high-ranking resolution. New knowledge on climate and plant biodiversity changes of large catchment areas can be obtained by this novel approach, relevant for future estimates of climate change effects.

Dating glaciers is an arduous yet essential task in ice core studies, which becomes even more challenging when dating glaciers suffering from mass loss in the accumulation zone as result of climate warming. In this context, we dated a 46 m deep ice core from the Central Italian Alps retrieved in 2016 from the Adamello glacier in the locality Pian di Neve (3100 m a.s.l.). Here we present a timescale for the core obtained by integrating results from the analyses of the radionuclides 210Pb and 137Cs with annual layer counting derived from pollen and refractory black carbon concentrations. Our results clearly indicate that the surface of the glacier is older than the drilling date of 2016 by about 20 years and that the 46 m ice core reaches back to around 1944. Despite the severe mass loss affecting this glacier even in the accumulation zone, we show that it is possible to obtain a reliable timescale for such a temperate glacier. Our results are therefore very encouraging and open new perspectives on the potential of such glaciers as informative palaeoarchives.

Many interpretations have been proposed to explain the presence of jarosite within Martian surficial sediments, including the possibility that it precipitated within paleo-ice deposits owing to englacial weathering of dust. However, until now a similar geochemical process was not observed on Earth nor in other planetary settings. We report a multi-analytical indication of jarosite formation within deep ice. Below 1000 m depth, jarosite crystals adhering on residual silica-rich particles have been identified in the Talos Dome ice core (East Antarctica) and interpreted as products of weathering involving aeolian dust and acidic atmospheric aerosols. The progressive increase of ice metamorphism and re-crystallization with depth, favours the relocation and concentration of dust and the formation of acidic brines in isolated environments, allowing chemical reactions and mineral neo-formation to occur. This is the first described englacial diagenetic mechanism occurring in deep Antarctic ice and supports the ice-weathering model for jarosite formation on Mars, highlighting the geologic importance of paleo ice-related processes on this planet. Additional implications concern the preservation of dust-related signals in deep ice cores with respect to paleoclimatic reconstructions and the englacial history of meteorites from Antarctic blue ice fields.

Both biotic and abiotic components, characterizing the mountain treeline ecotone, respond differently to climate variations. This study aims at reconstructing climate-driven changes by analyzing soil evolution in the late Holocene and by assessing the climatic trends for the last centuries and years in a key high-altitude climatic treeline (2515 m a.s.l.) on the SW slope of the Becca di Viou mountain (Aosta Valley Region, Italy). This approach is based on soil science and dendrochronological techniques, together with daily air/soil temperature monitoring of four recent growing seasons. Direct measurements show that the ongoing soil temperatures during the growing season, at the treeline and above, are higher than the predicted reference values for the Alpine treeline. Thus, they do not represent a limiting factor for tree establishment and growth, including at the highest altitudes of the potential treeline (2625 m a.s.l.). Dendrochronological evidences show a marked sensitivity of tree-ring growth to early-summer temperatures. During the recent 10-year period 2006–2015, trees at around 2300 m a.s.l. have grown at a rate that is approximately 1.9 times higher than during the 10-year period 1810–1819, one of the coolest periods of the Little Ice Age. On the other hand, soils show only an incipient response to the ongoing climate warming, likely because of its resilience regarding the changeable environmental conditions and the different factors influencing the soil development. The rising air temperature, and the consequent treeline upward shift, could be the cause of a shift from Regosol to soil with more marked Umbric characteristics, but only for soil profiles located on the N facing slopes. Overall, the results of this integrated approach permitted a quantification of the different responses in abiotic and biotic components through time, emphasizing the influence of local station conditions in responding to the past and ongoing climate change.

Objectives: To evaluate the failure rate and performance of cell-free DNA (cfDNA) testing as a first-line screening method for major trisomies, performed by two laboratories using different analytical methods: a targeted chromosome-selective method (Harmony® prenatal Test) versus a home-brew genome-wide (GW) massively parallel sequencing method (HB-cfDNA test), and to evaluate the clinical value of incidental findings for the latter method. Methods: CfDNA testing was performed in 3137 pregnancies with the Harmony® prenatal Test and in 3373 pregnancies with the HB-cfDNA test. Propensity score analysis was used to match women between both groups for maternal age, weight, gestational age at testing, in vitro fertilization, rate of twin pregnancies and that of aneuploidies. Detection rates for trisomy 21 were compared between the 2 laboratories. For the HB-cfDNA test, cases with rare incidental findings were reported, including their clinical follow-up. Results: The Harmony® prenatal Test failed at the first attempt in 90 (2.9%) of 3114 women and the HB-cfDNA test in 413 (12.2%) of 3373 women. Postmatched comparisons of the women’s characteristics indicate a significantly lower failure rate in the Harmony® group (2.8%) than in the HB cfDNA group (12.4%; p <.001). Of the 90 women in whom the Harmony® prenatal Test failed, 61 had a repeat test, which still failed in 10, and of the 413 women in whom the HB-cfDNA test failed, 379 had a repeat test, which still failed in 110. The total failure rate after one or two attempts was therefore 1.3% (39/3114) for Harmony® and 4.3% (144/3373) for the HB cfDNA test. After the first or second Harmony® prenatal Test, a high-risk result was noted in 17 of the 17 cases with trisomy 21, in 5 of the seven cases with trisomy 18, and a no-call in two cases, and in the one case with trisomy 13. The respective numbers for the HB-cfDNA test are 17 of the 18 cases with trisomy 21, and a no-call in one case, 2 of the two cases with trisomy 18, an, SCOPUS: ar.j, info:eu-repo/semantics/published