Bankfull curves for the temperate rainforests in the Southern Appalachian Mountains of Western North Carolina

Bankfull hydraulic geometry relationships, also called regional curves, relate bankfull stream channel dimensions and discharge to watershed drainage area. This paper describes results of bankfull curve relationships developed for the temperate rainforests of the Southern Appalachian Mountains primarily on Western North Carolina Mountain streams in the Southeastern United States. Gauge stations for small and larger catchments were selected with a range of 10 to 50 years of continuous or peak discharge measurements, no major impoundments, no significant change in land use over the past 10 years, and impervious cover ranges of <20%. Cross-sectional and longitudinal surveys were measured at each study reach to determine channel dimension, pattern, and profile information. Log-Pearson Type III distributions were used to analyze annual peak discharge data for nine small watersheds sites gauged by the United States Department of Agriculture (USDA), Forest Service, Southern Research Station, Coweeta Hydrologic Laboratory and for eleven larger watersheds gauged by the United States Geological Survey (USGS). Power function relationships were developed using regression analyses for bankfull discharge, channel cross-sectional area, mean depth, and width as functions of watershed drainage area

Determinants of the decision-to-delivery interval and the effect on perinatal outcome after emergency caesarean delivery: a cross-sectional study

BackgroundPreventing prolongation of the decision-to-delivery interval (DDI) for emergency caesarean delivery (CD) remains central to improving perinatal health. This study evaluated the effects of the DDI on perinatal outcome following emergency CD. MethodsA prospective cross-sectional study involving 205 consenting women who had emergency CD at a tertiary hospital in Nigeria was conducted. The time–motion documentation of events from decision to delivery was documented; the outcome measures were perinatal morbidity (neonatal resuscitation, 5-minute Apgar score, neonatal intensive admission) and mortality. Data analysis was performed with IBM SPSS Statistics version 20.0, and P&lt;0.05 was considered significant.ResultsThe overall mean DDI was 233.99±132.61 minutes (range 44–725 minutes); the mean DDI was shortest for cord prolapse (86.25±86.25 minutes) and was shorter for booked participants compared with unbooked participants (207.19±13.88 minutes vs 249.25±12.05 minutes; P=0.030) and for general anaesthesia compared with spinal anaesthesia (219.48±128.60 minutes vs 236.19±133.42 minutes; P=0.543). All neonatal parameters were significantly worse for unbooked women compared with booked women, including perinatal mortality (10.8% vs 1.3%; P=0.012). Neonatal morbidity increased with DDI for clinical indications, UK National Institute of Health and Care Excellence (NICE) and Robson classification for CDs; perinatal mortality was 73.2 per 1000 live births, all were category 1 CDs and all except one occurred with DDI greater than 90 minutes. Severe preeclampsia/eclampsia, obstructed labour and placenta praevia tolerated DDI greater than 90 minutes compared with abruptio placentae and umbilical cord prolapse. However, logistic regression showed no statistical correlation between the DDI and neonatal outcomes. ConclusionPerinatal morbidity and mortality increased with DDI relative to the clinical urgency but perinatal deaths were increased with DDI greater than 90 minutes. For no category of emergency CD should the DDI exceed 90 minutes, while patient and institutional factors should be addressed to reduce the DDI

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Mineralization Rates of Soil Forms of Nitrogen, Phosphorus, and Potassium as Affected by Organomineral Fertilizer in Sandy Loam

Farmers tend to use organomineral fertilizers as a result of inadequacies embedded in the sole use of organic and mineral fertilizers. A laboratory incubation study to determine the rate of the forms of N, P, and K released by organomineral fertilizer was conducted at Adeyemi College of Education, Ondo, southwest Nigeria, in 2013. Organomineral fertilizer (OMF) at the rates of 0, 0.125, 0.25, 0.5, and 1.0 g/100 g soil to represent 0, 2.5, 5, 10, and 20 t ha−1 OMF, respectively, was incubated for ninety days. The treatments were replicated three times and arranged in a completely randomized design. The determined forms of N were total N, NH4–N, and NO3–N; the forms of P were total P, solution P, and available P while the forms of K were total K, solution K, and exchangeable K. Organomineral fertilizer significantly increased N, NH4–N, NO3–N, total P, solution P, exchangeable P, solution K, and exchangeable K at all rates with different values. The rate of ammonification of N was higher than the rate of nitrification of NH4 + N to NO3 + N especially at 10 and 20 t ha−1 OMF. Application of 5 and 10 t ha−1 OMF could be used to increase soil forms of N, P, and K