Predicting the dispersal of SARS-CoV-2 RNA from the wastewater treatment plant to the coast

Viral pathogens including SARS-CoV-2 RNA have been detected in wastewater treatment effluent, and untreated sewage overflows, that pose an exposure hazard to humans. We assessed whether SARS-CoV-2 RNA was likely to have been present in detectable quantities in UK rivers and estuaries during the first wave of the Covid-19 pandemic. We simulated realistic viral concentrations parameterised on the Camel and Conwy catchments (UK) and their populations, showing detectable SARS-CoV-2 RNA concentrations for untreated but not for treated loading, but also being contingent on viral decay, hydrology, catchment type/shape, and location. Under mean or low river flow conditions, viral RNA concentrated within the estuaries allowing for viral build-up and caused a lag by up to several weeks between the peak in community infections and the viral peak in the environment. There was an increased hazard posed by SARS-CoV-2 RNA with a T90 decay rate >24 h, as the estuarine build-up effect increased. High discharge events transported the viral RNA downstream and offshore, increasing the exposure risk to coastal bathing waters and shellfisheries – although dilution in this case reduced viral concentrations well below detectable levels. Our results highlight the sensitivity of exposure to viral pathogens downstream of wastewater treatment, across a range of viral loadings and catchment characteristics – with implications to environmental surveillance

Regional conditions cause contrasting behaviour in U-isotope fractionation in black shales: Constraints for global ocean palaeo-redox reconstructions

The U-isotope system is a well-established palaeo-redox proxy that potentially constrains the global extent of marine anoxia during average as well as extreme redox events throughout Earth's history. A typical archive that forms underneath a reducing water column and acts as an intense U sink is organic-rich black shale. However, the degree to which black shale archives reflect the marine U-isotope signature is not well understood because U-isotope fractionation between U(VI)-bearing seawater and U(IV)-bearing black shales may vary as a function of local environmental conditions. Here, we present a combination of U-isotope and elemental concentration datasets, supported by a complementary Mo-isotope record, for the Furlo sedimentary section in Marche–Umbria, Italy and interrogate the combined systematics to unravel the mechanisms controlling the U-isotope fractionation factor between black shales and ambient seawater. We examine black shales deposited before and during Oceanic Anoxic Event 2 (OAE 2), which was one of the most extreme climatic perturbations of the Mesozoic Era that took place around the Cenomanian–Turonian boundary (Late Cretaceous, c. 94 Ma). The results of this study show that the U-isotope signature in the black shales deposited before OAE 2 was controlled by different mechanisms than the U-isotope ratios recorded in black shales deposited during OAE 2, with both stratigraphic intervals likely influenced by local environmental conditions. Probable local environmental changes include increased U reduction associated with biomass at or above the sediment–water interface and varying dissolved hydrogen sulphide concentrations in the water column and sediment. The overall results of this study confirm that black shales are a highly complex archive for U-isotope studies of past oceanic redox conditions, due to the sensitivity of the U-isotope fractionation mechanism to local environmental conditions, which are difficult to constrain. We propose the application of a ∆238Ushale-seawater of 0.6 ± 0.1 ‰ to black shale records deposited under locally constant euxinic conditions at non-restricted settings

Preparation, structural, dielectric and magnetic properties of LaFeO3-PbTiO3 solid solutions

Solid solutions of (1-x)LaFeO3-(x)PbTiO3 (0<x<1) have been prepared by conventional solid-state reaction. These complex perovskites have been studied by means of X-ray (XRPD) and neutron powder (NPD) diffraction, complemented with dielectric, magnetic, heat capacity and M\"ossbauer measurements. Complete solubility in the perovskite series was demonstrated. The NPD and XRPD patterns were successfully refined as orthorhombic (x \leq 0.7) and tetragonal (x \geq 0.8). A composition-driven phase transformation occurs within the interval 0.7<x<0.8. The samples with x<0.5 showed evidence of long-range magnetic ordering with an G-type antiferromagnetic arrangement of the magnetic moments of the Fe3+ cations in the B-site with propagation vector k = (0,0,0). Based on the obtained experimental data, a combined structural and magnetic phase diagram has been constructed. The factors governing the structural, dielectric and magnetic properties of (1-x) LaFeO3 - (x)PbTiO3 solid solutions are discussed, as well as their possible multiferroicity.Comment: 33 pages, 15 figure

A branching, positive relief network in the middle member of the Medusae Fossae Formation, Equatorial Mars - evidence for sapping?

The Medusae Fossae Formation (MFF) is a geological formation comprising three geological units (members) spread across five principal lobes. It dominates a quarter of the longitudinal extent of the equatorial region of Mars. Positive relief features referred to as ‘sinuous ridges' (commonly interpreted as inverted paleoflow channel or valley fills) have been observed in the lowest member of the western MFF, but have not been identified within the central and eastern portions of the formation, in the middle and upper members. This paper presents the identification and analysis of a branching, positive relief system which occurs in the central lobe of the MFF in what appears to be an exposure of the middle member. A simple geomorphological map of the system is presented, from which we have adopted the working hypothesis that this is an inverted fill of a branching fluvial channel or valley system. A suite of morphological and topographic evidence supporting this hypothesis is presented, including analysis of the network using a~15 m per pixel digital terrain model derived from a Context Imager (CTX) stereo image pair. The evidence supporting this hypothesis includes: 1) The local slope and topography of the upper surface of the network are consistent with a contributory network, 2) The braided, fan-like form at the termination of the branching network is consistent in morphology with it being a depositional fan at the end of a fluvial system, 3) The terminal fan and surrounding deposits show layering and polygonization, 4) There is strong association between the lower order branches and amphitheater shaped scarps in the depression walls. We evaluate the possible origins of this fluvial system and suggest that seepage sapping is the most probable. Two possible models for the evolution of the network and related features are presented; both require melt of ice within the MFF to form liquid water. We conclude that at least some portions of the Medusae Fossae Formation, if not the entire formation, were once volatile-rich. Finally, we note that our observations do not rule out the case that this network formed before MFF emplacement, and has since been exhumed. However, this conclusion would suggest that much of the surrounding terrain, currently mapped as middle-member MFF, is not in fact MFF material at all

The Cholecystectomy As A Day Case (CAAD) Score: A Validated Score of Preoperative Predictors of Successful Day-Case Cholecystectomy Using the CholeS Data Set

Background Day-case surgery is associated with significant patient and cost benefits. However, only 43% of cholecystectomy patients are discharged home the same day. One hypothesis is day-case cholecystectomy rates, defined as patients discharged the same day as their operation, may be improved by better assessment of patients using standard preoperative variables. Methods Data were extracted from a prospectively collected data set of cholecystectomy patients from 166 UK and Irish hospitals (CholeS). Cholecystectomies performed as elective procedures were divided into main (75%) and validation (25%) data sets. Preoperative predictors were identified, and a risk score of failed day case was devised using multivariate logistic regression. Receiver operating curve analysis was used to validate the score in the validation data set. Results Of the 7426 elective cholecystectomies performed, 49% of these were discharged home the same day. Same-day discharge following cholecystectomy was less likely with older patients (OR 0.18, 95% CI 0.15–0.23), higher ASA scores (OR 0.19, 95% CI 0.15–0.23), complicated cholelithiasis (OR 0.38, 95% CI 0.31 to 0.48), male gender (OR 0.66, 95% CI 0.58–0.74), previous acute gallstone-related admissions (OR 0.54, 95% CI 0.48–0.60) and preoperative endoscopic intervention (OR 0.40, 95% CI 0.34–0.47). The CAAD score was developed using these variables. When applied to the validation subgroup, a CAAD score of ≤5 was associated with 80.8% successful day-case cholecystectomy compared with 19.2% associated with a CAAD score >5 (p < 0.001). Conclusions The CAAD score which utilises data readily available from clinic letters and electronic sources can predict same-day discharges following cholecystectomy

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

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

The variability of the facial artery in its branching pattern and termination point and its relevance in craniofacial surgery

&lt;br&gt;Background: It is believed that by classifying the branching patterns of the facial artery, surgeons will have a better understanding of arterial distribution across the face, resulting in a greater success rate with regards to facial reconstructive surgery using this vessel. However, there is still a dispute within the literature as to how the facial artery should be classified. The purpose of this study was to identify the branching pattern and termination point of the facial artery and to establish if these classifications corresponded to those in the literature.&lt;/br&gt; &lt;br&gt;Methods: The facial artery was dissected in 21 adult embalmed Caucasian cadavers. A superficial pre-auricular incision was made in the coronal plane anterior to the auricle, extending from the tragus to approximately the mid-point on the sternocleidomastoid muscle. The skin and platysma were retracted anteriorly to expose the facial artery.&lt;/br&gt; &lt;br&gt;Results: Twenty-five different arterial branching patterns and six main termination points over 40 facial arteries were found. Some of the patterns found correlated with those described within the literature, whilst many were unique to this investigation.&lt;/br&gt; &lt;br&gt;Conclusions: The wide variation in the branching pattern and termination point of the facial artery demonstrates the difficulty in producing classification patterns for this vessel. It also raises the question on the usefulness of producing classification patterns. With the increasing use of pre-operative imaging and planning, coupled with meticulous dissection of every branch of the artery intra-operatively, it may have no clinical relevance producing many sub-classification patterns of arterial variation.&lt;/br&gt