Influence of a cattle access point on temporal changes in stream turbidity

Unrestricted cattle access can have negative impacts on aquatic systems, including increases in stream water turbidity and suspended sediment levels. Many agri-environmental policies require the exclusion of livestock from waterbodies; however, data that quantify these impacts are scarce. This study used sensors measuring turbidity, a proxy for suspended sediment, together with motion-detecting cameras, to examine the influence of cattle in-stream activity on water quality in north-east Ireland. Two nephelometers, which automatically measured and logged turbidity, were placed upstream and downstream of a cattle access point in July 2017, while cameras were used to record cattle behaviour. A second deployment was made during February 2018 when cattle were absent. During low flows, frequent short-lived increases in turbidity were recorded at the downstream nephelometer only. These coincided with cattle accessing the water. There was a significant positive relationship between the longitudinal differences (downstream − upstream) in turbidity and the total number of cattle accessing the stream. There was no relationship between turbidity and stream discharge in July (when cattle were present), although that period was dominated by lower flow levels, with only 2 days in which discharge increased above baseflow. In contrast, there were no similar short-lived increases in turbidity in February 2018 when cattle were absent from the field, but there was a strong significant positive relationship between stream discharge and turbidity. These results highlight the consequences of cattle access for water column turbidity levels, particularly during periods of low streamflow, and therefore inform future agri-environmental policy in Ireland

In-hospital case fatality rates for acute myocardial infarction in Romania

Background: We describe the clinical characteristics, treatments and in-hospital case-fatality rates in an unselected population of patients admitted for acute myocardial infarction. Methods: From January 2000 to June 2007, we tracked consecutive patients who were admitted to 7 tertiary referral and 21 county hospitals in Romania for medical treatment of ST-segment elevation acute myocardial infarction. These patients were enrolled in the Romanian Registry for ST-segment Elevation Myocardial Infarction. For this prospective study, we collected data on demographic characteristics, cardiovascular risk factors, various aspects of treatment for myocardial infarction, and in-hospital death. Results: The 9186 patients in the study group had a mean age of 63.8 years. The median time from onset of symptoms to thrombolysis was 230 (interquartile range 120-510) minutes. Of the 9186 patients, 4986 (54.3%) had hypertension, 1974 (21.5%) had diabetes mellitus, 3545 (38.6%) had lipid disorders and 4653 (50.7%) were smokers. The in-hospital mortality rate was 12.7% (1170 deaths). The study group consisted of 2893 women and 6293 men. The women were older than the men and had higher rates of hypertension and diabetes mellitus but were less likely to be smokers. A smaller proportion of women than men presented within 2 hours after onset of symptoms (23.1% v. 34.4%, p < 0.001). Smaller proportions of women received thrombolytics (40.8% v. 53.5%, p < 0.001), anticoagulants (93.4% v. 95.2%; p = 0.001), antiplatelet agents (88.3% v. 91.2%, p < 0.001) and primary percutaneous coronary interventions (1.5% v. 2.2%, p = 0.030). The risk of in-hospital death was greater for women, even after adjustment for confounders (odds ratio 1.33, 95% confidence interval 1.13-1.56; p < 0.001). Interpretation: The rates of reperfusion therapy for patients with acute myocardial infarction were low, and in-hospital case-fatality rates were high in this study. Excess in-hospital mortality was more pronounced among women