The environmental and geomorphological impacts of historical gold mining in the Ohinemuri and Waihou river catchments, Coromandel, New Zealand

Between 1875 and 1955 approximately 250,000 Mg yr− 1 of mercury-, arsenic-, and cyanide-contaminated mine tailings were discharged directly into the Ohinemuri River and its tributaries, in the Coromandel Region, North Island, New Zealand. A devastating flood on 14 January 1907 deposited large amounts of mine waste across the floodplain of the Ohinemuri and Waihou rivers in the vicinity of the township of Paeroa. The 1907 mine-waste flood deposit was located as a dirty yellow silt in cores and floodplain profiles, with a thickness ranging from 0.15–0.50 m. Geochemical analysis of the mine waste shows elevated concentrations of Pb (~ 200–570 mg kg− 1) and As (~ 30–80 mg kg− 1), compared to early Holocene background concentrations (Pb < 30 mg kg− 1; As < 17 mg kg− 1). Bulk sediment samples recovered from the river channel and overbank deposits also show elevated concentrations of Pb (~ 110 mg kg− 1), Zn (~ 140–320 mg kg− 1), Ag (~ 3 mg kg− 1), and Hg (~ 0.4 mg kg− 1). Using the mine-waste deposit as a chronological marker shows that sedimentation rates increased from ~ 0.2 mm yr− 1 in the early Holocene, to 5.5–26.8 mm yr− 1 following the 1907 flood. Downstream trends in the thickness of the flood deposit show that local-scale geomorphic factors are a significant influence on the deposition of mine waste in such events. Storage of mine waste is greatest in the upstream reaches of the floodplain. The volume of mine waste estimated to be stored in the Ohinemuri floodplain is ~ 1.13 M m3, an order of magnitude larger than recent well-publicised tailings-dam failures, such as the 1996 South America Porco, 2000 Romanian Baia Mare and Baia Borsa accidents, and constituted, and was recognised at the time, a significant geomorphological and environmental event. The mine-waste material remains in the floodplain today, representing a sizable legacy store of contaminant metals and metalloids that pose a long-term risk to the Ohinemuri and Waihou ecosystems

Epidemiology, practice of ventilation and outcome for patients at increased risk of postoperative pulmonary complications

BACKGROUND Limited information exists about the epidemiology and outcome of surgical patients at increased risk of postoperative pulmonary complications (PPCs), and how intraoperative ventilation was managed in these patients. OBJECTIVES To determine the incidence of surgical patients at increased risk of PPCs, and to compare the intraoperative ventilation management and postoperative outcomes with patients at low risk of PPCs. DESIGN This was a prospective international 1-week observational study using the ‘Assess Respiratory Risk in Surgical Patients in Catalonia risk score’ (ARISCAT score) for PPC for risk stratification. PATIENTS AND SETTING Adult patients requiring intraoperative ventilation during general anaesthesia for surgery in 146 hospitals across 29 countries. MAIN OUTCOME MEASURES The primary outcome was the incidence of patients at increased risk of PPCs based on the ARISCAT score. Secondary outcomes included intraoperative ventilatory management and clinical outcomes. RESULTS A total of 9864 patients fulfilled the inclusion criteria. The incidence of patients at increased risk was 28.4%. The most frequently chosen tidal volume (VT) size was 500 ml, or 7 to 9 ml kg1 predicted body weight, slightly lower in patients at increased risk of PPCs. Levels of positive end-expiratory pressure (PEEP) were slightly higher in patients at increased risk of PPCs, with 14.3% receiving more than 5 cmH2O PEEP compared with 7.6% in patients at low risk of PPCs (P < 0.001). Patients with a predicted preoperative increased risk of PPCs developed PPCs more frequently: 19 versus 7%, relative risk (RR) 3.16 (95% confidence interval 2.76 to 3.61), P < 0.001) and had longer hospital stays. The only ventilatory factor associated with the occurrence of PPCs was the peak pressure. CONCLUSION The incidence of patients with a predicted increased risk of PPCs is high. A large proportion of patients receive high VT and low PEEP levels. PPCs occur frequently in patients at increased risk, with worse clinical outcome

Epidemiology, practice of ventilation and outcome for patients at increased risk of postoperative pulmonary complications: LAS VEGAS - An observational study in 29 countries

BACKGROUND Limited information exists about the epidemiology and outcome of surgical patients at increased risk of postoperative pulmonary complications (PPCs), and how intraoperative ventilation was managed in these patients. OBJECTIVES To determine the incidence of surgical patients at increased risk of PPCs, and to compare the intraoperative ventilation management and postoperative outcomes with patients at low risk of PPCs. DESIGN This was a prospective international 1-week observational study using the ‘Assess Respiratory Risk in Surgical Patients in Catalonia risk score’ (ARISCAT score) for PPC for risk stratification. PATIENTS AND SETTING Adult patients requiring intraoperative ventilation during general anaesthesia for surgery in 146 hospitals across 29 countries. MAIN OUTCOME MEASURES The primary outcome was the incidence of patients at increased risk of PPCs based on the ARISCAT score. Secondary outcomes included intraoperative ventilatory management and clinical outcomes. RESULTS A total of 9864 patients fulfilled the inclusion criteria. The incidence of patients at increased risk was 28.4%. The most frequently chosen tidal volume (V T) size was 500 ml, or 7 to 9 ml kg−1 predicted body weight, slightly lower in patients at increased risk of PPCs. Levels of positive end-expiratory pressure (PEEP) were slightly higher in patients at increased risk of PPCs, with 14.3% receiving more than 5 cmH2O PEEP compared with 7.6% in patients at low risk of PPCs (P ˂ 0.001). Patients with a predicted preoperative increased risk of PPCs developed PPCs more frequently: 19 versus 7%, relative risk (RR) 3.16 (95% confidence interval 2.76 to 3.61), P ˂ 0.001) and had longer hospital stays. The only ventilatory factor associated with the occurrence of PPCs was the peak pressure. CONCLUSION The incidence of patients with a predicted increased risk of PPCs is high. A large proportion of patients receive high V T and low PEEP levels. PPCs occur frequently in patients at increased risk, with worse clinical outcome.</p

Geographical and temporal distribution of SARS-CoV-2 clades in the WHO European Region, January to June 2020

We show the distribution of SARS-CoV-2 genetic clades over time and between countries and outline potential genomic surveillance objectives. We applied three available genomic nomenclature systems for SARS-CoV-2 to all sequence data from the WHO European Region available during the COVID-19 pandemic until 10 July 2020. We highlight the importance of real-time sequencing and data dissemination in a pandemic situation. We provide a comparison of the nomenclatures and lay a foundation for future European genomic surveillance of SARS-CoV-2.Peer reviewe