Cenozoic environmenal shifts and foraminiferal evolution

The dense record of Cenozoic foraminifera simultaneously supplies a mosaic of biostratigraphy, a rich field for evolutionary studies and the vehicles for geochemical environmental proxies. Four groups are discussed: the larger foraminifera on the warm-water shelves and platforms, the planktonics, the deep-sea faunas and the southern-extratropical benthics. The environmental trajectory from greenhouse in the later Cretaceous and earlier Paleogene to icehouse in the Neogene is not smooth but punctuated, and there are two particularly critical intervals, later Eocene and early-middle Miocene. The foraminiferal record is not smooth but chunky at 107 years’ scale. There are several good examples of two powerful synchroneities, one being between the faunas of the different realms and the other between the fossil record and the physical-environmental record.Brian McGowra

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Background Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population.The aim of this study was to inform vaccination prioritization by modelling the impact of vaccination on elective inpatient surgery. The study found that patients aged at least 70 years needing elective surgery should be prioritized alongside other high-risk groups during early vaccination programmes. Once vaccines are rolled out to younger populations, prioritizing surgical patients is advantageous