Mobilisation of arsenic from bauxite residue (red mud) affected soils: effect of pH and redox conditions

The tailings dam breach at the Ajka alumina plant, western Hungary in 2010 introduced ~1 million m3 of red mud suspension into the surrounding area. Red mud (fine fraction bauxite residue) has a characteristically alkaline pH and contains several potentially toxic elements, including arsenic. Aerobic and anaerobic batch experiments were prepared using soils from near Ajka in order to investigate the effects of red mud addition on soil biogeochemistry and arsenic mobility in soil–water experiments representative of land affected by the red mud spill. XAS analysis showed that As was present in the red mud as As(V) in the form of arsenate. The remobilisation of red mud associated arsenate was highly pH dependent and the addition of phosphate to red mud suspensions greatly enhanced As release to solution. In aerobic batch experiments, where red mud was mixed with soils, As release to solution was highly dependent on pH. Carbonation of these alkaline solutions by dissolution of atmospheric CO2 reduced pH, which resulted in a decrease of aqueous As concentrations over time. However, this did not result in complete removal of aqueous As in any of the experiments. Carbonation did not occur in anaerobic experiments and pH remained high. Aqueous As concentrations initially increased in all the anaerobic red mud amended experiments, and then remained relatively constant as the systems became more reducing, both XANES and HPLC–ICP-MS showed that no As reduction processes occurred and that only As(V) species were present. These experiments show that there is the potential for increased As mobility in soil–water systems affected by red mud addition under both aerobic and anaerobic conditions

Highlights From the Annual Meeting of the American Epilepsy Society 2022

With more than 6000 attendees between in-person and virtual offerings, the American Epilepsy Society Meeting 2022 in Nashville, felt as busy as in prepandemic times. An ever-growing number of physicians, scientists, and allied health professionals gathered to learn a variety of topics about epilepsy. The program was carefully tailored to meet the needs of professionals with different interests and career stages. This article summarizes the different symposia presented at the meeting. Basic science lectures addressed the primary elements of seizure generation and pathophysiology of epilepsy in different disease states. Scientists congregated to learn about anti-seizure medications, mechanisms of action, and new tools to treat epilepsy including surgery and neurostimulation. Some symposia were also dedicated to discuss epilepsy comorbidities and practical issues regarding epilepsy care. An increasing number of patient advocates discussing their stories were intertwined within scientific activities. Many smaller group sessions targeted more specific topics to encourage member participation, including Special Interest Groups, Investigator, and Skills Workshops. Special lectures included the renown Hoyer and Lombroso, an ILAE/IBE joint session, a spotlight on the impact of Dobbs v. Jackson on reproductive health in epilepsy, and a joint session with the NAEC on coding and reimbursement policies. The hot topics symposium was focused on traumatic brain injury and post-traumatic epilepsy. A balanced collaboration with the industry allowed presentations of the latest pharmaceutical and engineering advances in satellite symposia

Immunoglobulin, glucocorticoid, or combination therapy for multisystem inflammatory syndrome in children: a propensity-weighted cohort study

Background: Multisystem inflammatory syndrome in children (MIS-C), a hyperinflammatory condition associated with SARS-CoV-2 infection, has emerged as a serious illness in children worldwide. Immunoglobulin or glucocorticoids, or both, are currently recommended treatments. Methods: The Best Available Treatment Study evaluated immunomodulatory treatments for MIS-C in an international observational cohort. Analysis of the first 614 patients was previously reported. In this propensity-weighted cohort study, clinical and outcome data from children with suspected or proven MIS-C were collected onto a web-based Research Electronic Data Capture database. After excluding neonates and incomplete or duplicate records, inverse probability weighting was used to compare primary treatments with intravenous immunoglobulin, intravenous immunoglobulin plus glucocorticoids, or glucocorticoids alone, using intravenous immunoglobulin as the reference treatment. Primary outcomes were a composite of inotropic or ventilator support from the second day after treatment initiation, or death, and time to improvement on an ordinal clinical severity scale. Secondary outcomes included treatment escalation, clinical deterioration, fever, and coronary artery aneurysm occurrence and resolution. This study is registered with the ISRCTN registry, ISRCTN69546370. Findings: We enrolled 2101 children (aged 0 months to 19 years) with clinically diagnosed MIS-C from 39 countries between June 14, 2020, and April 25, 2022, and, following exclusions, 2009 patients were included for analysis (median age 8·0 years [IQR 4·2–11·4], 1191 [59·3%] male and 818 [40·7%] female, and 825 [41·1%] White). 680 (33·8%) patients received primary treatment with intravenous immunoglobulin, 698 (34·7%) with intravenous immunoglobulin plus glucocorticoids, 487 (24·2%) with glucocorticoids alone; 59 (2·9%) patients received other combinations, including biologicals, and 85 (4·2%) patients received no immunomodulators. There were no significant differences between treatments for primary outcomes for the 1586 patients with complete baseline and outcome data that were considered for primary analysis. Adjusted odds ratios for ventilation, inotropic support, or death were 1·09 (95% CI 0·75–1·58; corrected p value=1·00) for intravenous immunoglobulin plus glucocorticoids and 0·93 (0·58–1·47; corrected p value=1·00) for glucocorticoids alone, versus intravenous immunoglobulin alone. Adjusted average hazard ratios for time to improvement were 1·04 (95% CI 0·91–1·20; corrected p value=1·00) for intravenous immunoglobulin plus glucocorticoids, and 0·84 (0·70–1·00; corrected p value=0·22) for glucocorticoids alone, versus intravenous immunoglobulin alone. Treatment escalation was less frequent for intravenous immunoglobulin plus glucocorticoids (OR 0·15 [95% CI 0·11–0·20]; p<0·0001) and glucocorticoids alone (0·68 [0·50–0·93]; p=0·014) versus intravenous immunoglobulin alone. Persistent fever (from day 2 onward) was less common with intravenous immunoglobulin plus glucocorticoids compared with either intravenous immunoglobulin alone (OR 0·50 [95% CI 0·38–0·67]; p<0·0001) or glucocorticoids alone (0·63 [0·45–0·88]; p=0·0058). Coronary artery aneurysm occurrence and resolution did not differ significantly between treatment groups. Interpretation: Recovery rates, including occurrence and resolution of coronary artery aneurysms, were similar for primary treatment with intravenous immunoglobulin when compared to glucocorticoids or intravenous immunoglobulin plus glucocorticoids. Initial treatment with glucocorticoids appears to be a safe alternative to immunoglobulin or combined therapy, and might be advantageous in view of the cost and limited availability of intravenous immunoglobulin in many countries. Funding: Imperial College London, the European Union's Horizon 2020, Wellcome Trust, the Medical Research Foundation, UK National Institute for Health and Care Research, and National Institutes of Health

Assessment of mineralogical, textural, and water chemistry changes during long-distance tailings-slurry transport

An exploratory study demonstrated that subtle changes in solids and process water were caused by long-distance turbulent transport of tailings from the concentrator to the impoundment of a Cu (Mo) porphyry copper deposit. Slurry water chemical analysis was complemented by modelling potential phase precipitation or dissolution and speciation of dissolved metals. It was found that transport did not affect major insoluble mineral phases. However, the degrees of liberation of several phyllosilicates, as determined by automated mineralogy, were reduced close to the impoundment, which points to separation of clay particles from tectosilicate surfaces by the turbulence; this also was observed by SEM examination of micro-aggregate specimens. Reduction of maximum particle sizes, increased N monolayer adsorption, and resultant specific surface areas indicate that transport modified the micro-aggregates. Major element water chemistry is controlled by the presence of soluble mineral phases, such as gypsum, and reagents, such as lime, in the flotation process. Changes in the dissolved concentrations of some elements could potentially affect tailings deportment in the impoundment. Increased concentrations of Al may affect the clay settling behaviour, while Mo and As levels will require treatment prior to the discharge of water from the tailings impoundment. This study demonstrated that systematic scrutiny of tailings slurries leaving the concentrator and before entering the impoundment can be potentially useful, though care will have to be exercised to replicate sample handling and analytical conditions, during any long-term monitoring

Geochemical cycles of arsenic in historic tin tailings from multiple ore sources : an example from Australia

In this work, we studied a geochemically unique abandoned tin mining tailings facility in tropical north Queensland, Australia. Tin mining residues from local operations were reprocessed and left without proper remediation, after which native plant species colonised this site over time. The aim of this study was to characterize the mine tailings to understand the geochemistry and predict the potential mobility and bioavailability of major contaminants, arsenic and tin. Major and trace minerals were identified with X-ray diffraction (XRD) and scanning electron microscopy with energy-dispersive X-ray spectroscopy (SEM-EDS). Acid digestion and sequential extraction procedures were used to quantify elemental concentrations and potential mobility. We found that the highly oxidized tailing cells were dominated by quartz with limited buffering capacity to prevent acid mine drainage formation, consequently creating an acidic environment (pH 4). Arsenic (As) and tin (Sn) were identified as the main contaminants in the tailings with concentrations of up to 2980 μg g−1 and 2910 μg g−1, respectively. Tin was mainly bound to the residual fraction (52% of total Sn) and crystalline Fe-oxide fraction (33% of total Sn), limiting its release and mobility. The bulk of As (~77% of total As) was present in the crystalline Fe-oxide fraction, while ~19% in the amorphous/poorly crystalline Fe-oxide fraction. The bioavailable As fraction was negligible (~1%), and this was confirmed by limited As accumulation in terrestrial and aquatic plants (Cyperaceae sp., Eleocharis equisetina, and Poaceae sp.) sampled at the site. This interdisciplinary study reveals biogeochemical properties of Sn tailings, the fate of As, and how native plants can thrive in this unfavourable environment. This information can potentially guide further phytostabilization efforts at this site

An iterative approach to case study analysis: insights from qualitative analysis of quantitative inconsistencies

Large-N comparative studies have helped common pool resource scholars gain general insights into the factors that influence collective action and governance outcomes. However, these studies are often limited by missing data, and suffer from the methodological limitation that important information is lost when we reduce textual information to quantitative data. This study was motivated by nine case studies that appeared to be inconsistent with the expectation that the presence of Ostrom’s Design Principles increases the likelihood of successful common pool resource governance. These cases highlight the limitations of coding and analysing Large-N case studies. We examine two issues: 1) the challenge of missing data and 2) potential approaches that rely on context (which is often lost in the coding process) to address inconsistencies between empirical observations theoretical predictions.  For the latter, we conduct a post-hoc qualitative analysis of a large-N comparative study to explore 2 types of inconsistencies: 1) cases where evidence for nearly all design principles was found, but available evidence led to the assessment that the CPR system was unsuccessful and 2) cases where the CPR system was deemed successful despite finding limited or no evidence for design principles.  We describe inherent challenges to large-N comparative analysis to coding complex and dynamically changing common pool resource systems for the presence or absence of design principles and the determination of “success”.  Finally, we illustrate how, in some cases, our qualitative analysis revealed that the identity of absent design principles explained inconsistencies hence de-facto reconciling such apparent inconsistencies with theoretical predictions.  This analysis demonstrates the value of combining quantitative and qualitative analysis, and using mixed-methods approaches iteratively to build comprehensive methodological and theoretical approaches to understanding common pool resource governance in a dynamically changing context

Ketamine to treat super-refractory status epilepticus

Objective To test ketamine infusion efficacy in the treatment of super-refractory status epilepticus (SRSE), we studied patients with SRSE who were treated with ketamine retrospectively. We also studied the effect of high doses of ketamine on brain physiology as reflected by invasive multimodality monitoring (MMM). Methods We studied a consecutive series of 68 patients with SRSE who were admitted between 2009 and 2018, treated with ketamine, and monitored with scalp EEG. Eleven of these patients underwent MMM at the time of ketamine administration. We compared patients who had seizure cessation after ketamine initiation to those who did not. Results Mean age was 53 +/- 18 years and 46% of patients were female. Seizure burden decreased by at least 50% within 24 hours of starting ketamine in 55 (81%) patients, with complete cessation in 43 (63%). Average dose of ketamine infusion was 2.2 +/- 1.8 mg/kg/h, with median duration of 2 (1-4) days. Average dose of midazolam was 1.0 +/- 0.8 mg/kg/h at the time of ketamine initiation and was started at a median of 0.4 (0.1-1.0) days before ketamine. Using a generalized linear mixed effect model, ketamine was associated with stable mean arterial pressure (odds ratio 1.39, 95% confidence interval 1.38-1.40) and with decreased vasopressor requirements over time. We found no effect on intracranial pressure, cerebral blood flow, or cerebral perfusion pressure. Conclusion Ketamine treatment was associated with a decrease in seizure burden in patients with SRSE. Our data support the notion that high-dose ketamine infusions are associated with decreased vasopressor requirements without increased intracranial pressure. Classification of evidence This study provides Class IV evidence that ketamine decreases seizures in patients with SRSE