Evolution of a Holocene delta driven by episodic sediment delivery and coseismic deformation, Puget Sound, Washington, USA

This paper is not subject to U.S. copyright. The definitive version was published in Sedimentology 53 (2006): 1211-1228, doi:10.1111/j.1365-3091.2006.00809.x.Episodic, large-volume pulses of volcaniclastic sediment and coseismic subsidence of the coast have influenced the development of a late Holocene delta at southern Puget Sound. Multibeam bathymetry, ground-penetrating radar (GPR) and vibracores were used to investigate the morphologic and stratigraphic evolution of the Nisqually River delta. Two fluvial–deltaic facies are recognized on the basis of GPR data and sedimentary characteristics in cores, which suggest partial emplacement from sediment-rich floods that originated on Mount Rainier. Facies S consists of stacked, sheet-like deposits of andesitic sand up to 4 m thick that are continuous across the entire width of the delta. Flat-lying, highly reflective surfaces separate the sand sheets and comprise important facies boundaries. Beds of massive, pumice- and charcoal-rich sand overlie one of the buried surfaces. Organic-rich material from that surface, beneath the massive sand, yielded a radiocarbon age that is time-correlative with a series of known eruptive events that generated lahars in the upper Nisqually River valley. Facies CF consists of linear sandbodies or palaeochannels incised into facies S on the lower delta plain. Radiocarbon ages of wood fragments in the sandy channel-fill deposits also correlate in time to lahar deposits in upstream areas. Intrusive, sand-filled dikes and sills indicate liquefaction caused by post-depositional ground shaking related to earthquakes. Continued progradation of the delta into Puget Sound is currently balanced by tidal-current reworking, which redistributes sediment into large fields of ebb- and flood-oriented bedforms.This study was supported by the Coastal and Marine Geology Program, and the Earthquake Hazards Program of the U.S. Geological Survey

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