AnaesthesiaEarly View Correspondence Clinical evidence needed for risks of PPE J. Kua, Corresponding Author J. Kua justin.kua@doctors.org.uk orcid.org/0000-0002-5741-2300 University College London, London, UKSearch for more papers by this authorE. Nurmi, E. Nurmi University College London Hospitals NHS Foundation Trust, London, UKSearch for more papers by this authorD. J. N. Wong, D. J. N. Wong orcid.org/0000-0002-3524-1766 Guy's and St Thomas' NHS Foundation Trust, London, UKSearch for more papers by this authorT. Potter, T. Potter Guy's and St Thomas' NHS Foundation Trust, London, UKSearch for more papers by this authorJ. N. Cronin, J. N. Cronin Guy's and St Thomas' NHS Foundation Trust, London, UKSearch for more papers by this authorK. El-Boghdadly, K. El-Boghdadly Guy's and St Thomas' NHS Foundation Trust, London, UKSearch for more papers by this author J. Kua, Corresponding Author J. Kua justin.kua@doctors.org.uk orcid.org/0000-0002-5741-2300 University College London, London, UKSearch for more papers by this authorE. Nurmi, E. Nurmi University College London Hospitals NHS Foundation Trust, London, UKSearch for more papers by this authorD. J. N. Wong, D. J. N. Wong orcid.org/0000-0002-3524-1766 Guy's and St Thomas' NHS Foundation Trust, London, UKSearch for more papers by this authorT. Potter, T. Potter Guy's and St Thomas' NHS Foundation Trust, London, UKSearch for more papers by this authorJ. N. Cronin, J. N. Cronin Guy's and St Thomas' NHS Foundation Trust, London, UKSearch for more papers by this authorK. El-Boghdadly, K. El-Boghdadly Guy's and St Thomas' NHS Foundation Trust, London, UKSearch for more papers by this author First published: 19 October 2022 https://doi.org/10.1111/anae.15895 KE is an editor of Anaesthesia. No other competing interests declared. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Early ViewOnline Version of Record before inclusion in an issue RelatedInformation

FloodWise is a pilot project that proposes innovative new approaches for flood disaster resilience by applying nature-based solutions (NBS) in Eastern North Carolina to control water runoff for brief periods after major storm events. We collected production and cost data from primary or secondary sources and used discounted cash flow and capital budgeting procedures at a 6% discount rate for NBS practices to estimate the amounts of payments necessary for farmland owners to break even to adopt NBS practices. Conventional crop farming was profitable already on suitable lands and served as the business as usual (BAU) case to compare to selected NBS practices. Warm-season pasture, loblolly pine forests and agroforestry, and no-till farming exceeded the 6% hurdle rate. Other conventional farm practices of hardpan breakup, cool-season pastures and trees, and bottomland hardwoods would require total payments of up to $600/acre to break even at 6%. Modifications of existing conservation practices, such as stream buffers, cover crops, silvopasture, and tile outlet terraces and tiling, fell in the second tier of total costs of up to $1,512/acre. Major NBS projects that required substantial earthmoving and flood control structures were more expensive - $3,734/acre for water farming (i.e., retention) with berms, $13,252/acre for a forest wetland bank, and about $88,000/acre for a major flood control wetland - and would displace most of the existing area for farm and forest management. However, larger floodwater structure projects could store more water for more extended periods; these storage quantities and benefits need to be assessed in future research.

Background and AimsVirtual Reality (VR) has been shown to reduce anxiety and pain scores for medical procedures, and in conjunction with regional anaesthesia (RA), has been reported to reduce sedation requirements, and improve patient satisfaction(1). We aimed to implement the use of VR for patients undergoing awake upper limb surgery under RA at our institution.MethodsThree Occulus Quest 2 VR headsets were kindly donated from Sintetica. The implementation process required several steps; local approval from clinical engineering and infection control to permit the use of these headsets on patients; establishing and troubleshooting the VR set up, which required disabling the boundary limit in order to have continuous use of the headset regardless of patient positioning; selecting appropriate media which included videos and immersive experiences. Patients who agreed to trial the VR headset were then asked for feedback.ResultsThe implementation of VR into our practice required technical preparation as well as local engagement to ensure multi-disciplinary awareness and buy-in, in particular from our ODPs and surgical colleagues. Initial feedback from surgeons and patients is positive, with reports noting the improved experience with VR in those with a history of previous surgeries under RA. Others noted the preferred media selection for future occurrences, such as documentaries or relaxing experiences, being mindful of which may result in nausea.ConclusionsA larger cohort of patients is required to evaluate the impact of VR as an adjunct to awake surgery on patient experience, but our preliminary service evaluation has provided very promising results.

The perceived risk of transmission of aerosolised viral particles from patients to airway practitioners during the COVID-19 pandemic led to the widespread use of aerosol precautions, including personal protective equipment and modifications to anaesthetic technique. The risk of these aerosol precautions on peri-operative airway complications has not been assessed outside of simulation studies. This prospective, national, multicentre cohort study aimed to quantify this risk. Adult patients undergoing general anaesthesia for elective or emergency procedures over a 96-hour period were included. Data collected included use of aerosol precautions by the airway practitioner, airway complications and potential confounding variables. Mixed-effects logistic regression was used to assess the risk of individual aerosol precautions on overall and specific airway complications. Data from 5905 patients from 70 hospital sites were included. The rate of airway complications was 10.0% (95%CI 9.2-10.8%). Use of filtering facepiece class 2 or class 3 respirators was associated with an increased risk of airway complications (odds ratio 1.38, 95%CI 1.04-1.83), predominantly due to an association with difficult facemask ventilation (odds ratio 1.68, 95%CI 1.09-2.61) and desaturation on pulse oximetry (odds ratio 2.39, 95%CI 1.26-4.54). Use of goggles, powered air-purifying respirators, long-sleeved gowns, double gloves and videolaryngoscopy were not associated with any alteration in the risk of airway complications. Overall, the use of filtering facepiece class 2 or class 3 respirators was associated with an increased risk of airway complications, but most aerosol precautions used during the COVID-19 pandemic were not.

Increased global temperatures resulting from anthropogenically induced climate changes have increased the frequency and severity of adverse weather events, including extreme rainfall events, floods, and droughts. In recent years, nature-based solutions (NBS) have been proposed to retain storm runoff temporarily and mitigate flood damages. These practices may help rural farm and forest lands to store runoff and reduce flooding on farms and downstream communities and could be incorporated into a conservation program to provide payments for these efforts, which would supplement traditional farm incomes. Despite their potential, there have been very few methodical assessments and detailed summaries of NBS to date. We identified and summarized potential flood reduction practices for the Coastal Plain of North Carolina. These include agricultural practices of (1) cover cropping/no-till farming; (2) hardpan breakup; (3) pine or (4) hardwood afforestation, and (5) agroforestry; establishing the wetland and stream practices of (6) grass and sedge wetlands and earthen retention structures, (7) forest wetland banks, and (8) stream channel restoration; and establishing new structural solutions of (9) dry dams and berms (water farming) and (10) tile drainage and water retention. These practices offer different water holding and storage capacities and costs. A mixture of practices at the farm and landscape level can be implemented for floodwater retention and attenuation and damage reduction, as well as for providing additional farm and forest ecosystem services.

The elemental composition of soil plays an essential role in crop nutrition, but losses from croplands can negatively impact soil fertility and water quality. We compared the impact of strip tillage (ST) and conventional tillage (CT) on element concentrations and loads in surface runoff and subsurface flow from plots under rotational cotton (Gossypium hirsutum L.) and peanut (Arachis hypogaea L.) production with winter cover cropping. Total element concentrations (calcium [Ca], iron [Fe], potassium [K], magnesium [Mg], manganese [Mn], sodium [Na], phosphorus [P], sulfur [S], silicon [Si], and zinc [Zn]) in surface runoff and subsurface flow samples were measured using Inductively Coupled Plasma with Optical Emission Spectroscopy (ICP-OES). Element loads were estimated by multiplying the element concentrations by the surface runoff and drainage volumes. Significantly greater (p ≤ 0.05) surface runoff loads for all elements (with the exception of K and Zn) were observed from the CT compared with the ST treatment plots only in 2006, likely due to the combined effects of hydrology and the timing of gypsum amendments that year. Surface runoff was the primary hydrologic pathway for Fe, K, Mn, P, Si, and Zn loss while subsurface flow was the primary hydrologic pathway for Ca, Mg, and S loss with both tillage treatments. Lower concentrations of Ca, Mg, Na, and S in the subsurface flow with ST compared to CT suggest that this tillage practice, in conjunction with the proper timing of fertilizer and soil amendment applications (e.g., poultry litter and gypsum) can be an effective method for reducing element losses from croplands. This finding highlights the importance of conservation practices in sustaining healthy cropland soils while reducing element losses and associated environmental impacts.

Global carbon (C) and nitrogen (N) cycles are closely linked to erosion and hydrologic processes. By reducing tillage erosion and runoff, sediment-bound C and N losses can be reduced. Published studies represent only a few soil types and regions and rarely directly compare tillage practices. The objective of this study was to quantify concentrations and sediment-bound total organic carbon (TOC) and nitrogen (TON) loads and enrichment ratios in runoff from 0.2-ha fields in rotational cotton (Gossypium hirsutwn L.)-peanut (Arachis hypogea L.) production during a 7-yr study within a southeastern USA coastal plain landscape. The Ultisoils at the study site have loamy sand to sandy loam texture surface horizons. The fields were in either continuous conventional tillage (CT) or strip tillage (ST) and were at upper, middle, and lower landscape positions. Sediment-bound TON and TOC concentrations were significantly greater from ST than CT fields as were the TOC and TON enrichment ratios. However, due to greater surface runoff and sediment loss, TON and TOC loads were significantly greater from CT than ST fields. The CT and ST loads were significantly different at the upper and middle but not at the lower landscape position. Enrichment ratios, 14 to 19 for TON and 8 to 12 for TOC, were several-fold greater than reported in the limited available literature, where studies focused on finer textured surface soils. Our findings have highlighted the site-specific nature of erosion processes, how they affect sediment-bound C and N loss in agricultural landscapes, and how reducing tillage may impact sediment C and N dynamics. The observed enrichment ratios can be used to modify or adjust values used in current erosion models and improve their suitability for use in the region and elsewhere where surface soils have sandy texture and when practices like ST are implemented.

Conservation tillage (CsT) involves management that reduces soil erosion by maintaining crop residue cover on farm fields. Typically, both infiltration and soil organic matter increase over time with CsT practices. We compared the impact of a commonly used CsT practice, strip tillage (ST), to conventional tillage (CT) management on soil nitrogen (N) dynamics and leaching and examined associations to soil N availability and microbial biomass. A winter cover crop was used in both tillage treatments. The study was conducted over a five-year period during rotational cotton (Gossypium hirsutum L.) and peanut (Arachis hypogaea L.) production in the Atlantic Coastal Plain region in Georgia, United States. Fertilizer and poultry litter were applied ahead of the cotton crops. Sets of PVC cylinders were filled with soil from each of six plots, three in ST and three in CT, and maintained in situ in their respective plots for 16 intervals of about 90 days. After retrieval, the soil in each cylinder was analyzed for inorganic N (ammonium and nitrates [NH4+ and NO3−]), total N, total carbon (C), and microbial biomass. Leached NO3−-N was captured on anion exchange resin-filled bags attached to the bottom of each cylinder. After the five-year study period, the ST and CT soil C content increased by 22% and 23%, respectively. Total soil N content increased 27% with ST compared to 22% with CT. Temporal patterns in NO3−-N leaching were not different between CT and ST treatments, and a high amount of NO3−-N leaching was observed after the application of poultry litter. The cumulative amount of NO3−-N leached from soils throughout the five-year study was 141 and 122 kg N ha−1 (126 and 109 lb N ac−1) with CT and ST practices, respectively. Results suggest that leaching from the top 15 cm (6 in) of soil may be an important pathway of N loss from both CT and ST cropping systems in the region. Regardless of tillage, soil microbial biomass N was equal to or higher than the total inorganic N, but still represented a small percentage (up to 9%) of the total soil N. Overall, microbial biomass N was higher in ST compared to CT. Minimizing NO3−-N in the soil from reaching ground and surface waters while increasing crop productivity represents a major challenge. The use of ST in conjunction with winter cover crops may improve plant N availability by more than 27 kg ha−1 y−1 (24 lb ac−1 yr−1) in the sandy landscapes of the southeastern Coastal Plain region through microbial cycling of organic N while reducing subsurface NO3−-N losses.

Cactoblastis cactorum (Berg.) is recognized as an invasive species in the Caribbean, the United States, and Mexico. Prior work using hexane extracts of sex glands showed that the sex pheromone of this species has 54% of (Z, E) ‐9.12 ‐14: acetate, 42% of (Z, E) ‐9.12 -14:OH and 4% of Z9‐14: Ac. Although traps baited with this mixture are effectively to attract males of the cactus moth, it is necessary to determine whether the pheromone can be optimized and to determinate if female diet may impact pheromone composition. Experiments with insects were made at the USDA‐ARS Crop in Tifton, Georgia, where there is a colony maintained on cactus and another on an artificial diet. Solid‐phase microextraction (SPME) was used to collect pheromones in the headspace above a single calling female and by rubbing the excised female sex gland with SPME fibers. Rubbing the gland directly with SPME fiber revealed that the pheromone consists of the compounds cited above plus Z9‐14:Ac. With dynamic aeration and capture of volatiles with fiber only captured two compounds. In addition, our results indicated that natural or artificial diet does not influence the composition of the sex pheromone.

The seed oil content of 305 genebank accessions of eggplant (Solanum melongena), five related species (S. aethiopicum L., S. incanum L., S. anguivi Lam., S. linnaeanum Hepper and P.M.L. Jaeger and S. macrocarpon L.) and 27 additional Solanums pecies, was determined by NMR. Eggplant (S. melongena) seed oil content varied from 17.2% (PI 63911317471) to 28.0% (GRIF 13962) with a mean of 23.7% (std. dev = 2.1) across the 305 samples. Seed oil content in other Solanum species varied from 11.8% (S. capsicoides-PI 370043) to 44.9% (S. aviculare-PI 420414). Fatty acids were also determined by HPLC in genebank accessions of S. melongena (55), S. aethiopicum (10), S. anguivi (4), S. incanum (4) and S. macrocarpon (2). In all samples examined, the predominant fatty acid was linoleic acid (18:2) followed by oleic acid (18:1) and palmitic acid (16:0). Levels of linoleic acid ranged from 57% (S. aethiopicum-PI 194166) to 74.5% (S. anguivi-PI 183357). Oleic and palmitic acid levels ranged from 11.3% (S. anguivi-PI 183357) to 25.2% (S. aethiopicum-PI 194166) and 8.4% (S. melongena-PI 115507) to 11.2% (S. melongena-PI 600912), respectively. Oil extracted from seed of S. melongena cv. Black Beauty had a pour point of -12°C, viscosities of 28.8 (40°C) and 7.3 (100°C), a viscosity index of 240, an oxidation onset temperature of 160°C and a Gardner Color of 6+.

Agrichemical runoff from farmland may adversely impact coastal water quality. Two models, the Agricultural Policy/Environmental eXtender (APEX) and the Riparian Ecosystem Management Model (REMM), were used to evaluate the movement of the herbicide atrazine to the Jobos Bay National Estuarine Research Reserve from adjacent fields. The reserve is located on Puerto Rico's southeast coast. Edge-of-field atrazine outputs simulated with the APEX were routed through a grass-forest buffer using the REMM. Atrazine DT50 (half-life) values measured in both field and buffer soils indicated that accelerated degradation conditions had developed in the field soil due to repeated atrazine application. APEX simulations examined both the measured field and buffer soil atrazine DT50 and the model's default value. The use of the measured field soil atrazine degradation rate in the APEX resulted in 33 % lower atrazine transport from the field. REMM simulations indicated that the buffer system had the potential to reduce dissolved atrazine transport in surface runoff by 77 % during non-tropical storm events by increasing infiltration, slowing transport, and increasing time for pesticide degradation. During a large runoff event due to a tropical storm that occurred close to the time of an atrazine application, the REMM simulated only a 37 % reduction in atrazine transport. The results indicate that large storm events soon after herbicide application likely dominate herbicide transport to coastal waters in the region. These results agree with water quality measurements in the reserve. This study demonstrated the sensitivity of these models to variations in DT50 values in evaluating atrazine fate and transport in the region and emphasizes that the use of measured DT50 values can improve model accuracy.

To control weeds with evolved resistance to glyphosate, Southeastern (USA) cotton farmers have increased fomesafen (5-(2-chloro-α,α,α-trifluoro-p-tolyloxy)-N-mesyl-2-nitrobenzamide) use. To refine fomesafen risk assessments, data are needed that describe its dissipation following application to farm fields. In our study, relatively low runoff rates and transport by lateral subsurface flow, <1.0 and 0.15% of applied respectively, were observed. The low runoff rate was linked to postapplication irrigation incorporation and implementation of a common conservation tillage practice. Moderate soil persistence (t1/2 = 100 days) was indicated in laboratory incubations with surface soil, however, analysis of soil cores from treated plots showed that ≈3% of fomesafen applied persisted in subsoil >3 years after application. Findings suggest low potential for fomesafen movement from treated fields, however, the fate of fomesafen that accumulated in subsoil and the identity of degradates are uncertain. Soil and water samples were screened for degradates, but, none were detected.

Pesticide volatilization and deposition with precipitation is widely documented and has been connected to adverse ecological impact. Here we describe a 3-yr study of current use and legacy pesticides in event-based rain samples within a 123-ha agricultural watershed. Crops in farm fields were documented quarterly with data used to estimate target compound use. The median number of pesticide detections in samples was 6. The fungicide, chlorothalonil which was used most intensively was detected in nearly all samples. It had the highest mean and peak concentrations with total deposition ≈0.1% of the estimated amount applied. The insecticide endosulfan also had relatively high use with behavior mirroring chlorothalonil. There was strong seasonal variation in concentration and depositional dynamics with the highest values measured during growing seasons. Similar behavior was observed with other compounds detected in rain samples with a general decrease in deposition and mean concentrations as use decreased. Comparison of measured concentrations to values associated with toxic impact on aquatic organisms indicated that chlorothalonil, endosulfan, chlorpyrifos, malathion and atrazine may contribute to adverse impact. The number of samples exceeding risk endpoints ranged from 1 to 77%. The highest value was for endosulfan; however its on-going phase-out is expected to reduce risks. Another finding was that the wet deposition of the herbicide, metolachlor exceeded measured runoff rates in the watershed by 5-fold. The study has demonstrated that localized pesticide wet deposition may present ecological risks and that volatilization and wet deposition is an important pesticide transport pathway at the local scale. Findings point to the need to include wet deposition in assessments of pesticide ecological risk and environmental fate.

Biochars were produced by pyrolysis of sugarcane bagasse (350°C and 700°C) and pine wood (400°C) and are abbreviated BC350, BC700, and WC400, respectively. Metribuzin adsorption by batch equilibrium showed that BC700 had the greatest adsorption capacity followed by BC350 and WC400. The bagasse biochars were mixed with clay and a silt loam soil and the pine wood biochar with a loamy sand soil and fortified with the metribuzin and pendimethalin. The soils were incubated at 25°C in the dark and were extracted with methanol after 0, 7, 14, 21, 28, 42, 63, 86, and 111 days. Parent compounds and metribuzin degradates were analyzed in extracts by HPLC – mass spectrometry. Increases in metribuzin half life (DT50) were indicated for all soil-biochar combinations. BC350 had the greatest impact, doubling the DT50 in the silt loam soil. In contrast, BC700 had minimal impact on the DT50 in the silt loam soil and contributed to a significant DT50 decrease in the clay. The metribuzin degradate, metribuzin-desamino, was detected at rates proportional to metribuzin dissipation. For pendimethalin, biochar additions increased DT50 in all soil-biochar combinations. In contrast to metribuzin, BC700 and WC400 had the greatest impact with the BC700 increasing the DT50 more than 2-fold. In the loamy sand soil, the 1–4% biochar rate contributed to an increased trend in palmer amaranth emergence. At the 8% rate, palmer amaranth emergence was statistically higher than the control (p=0.072). In sum, how biochar impacted the activity and dissipation of these herbicides depended on soil, herbicide, and biochar properties.

Growing populations and food demand in the tropics are leading to increased environmental pressures on wetland ecosystems, including a greater reliance on natural wetlands for water quality improvement. Effective assessment of wetland treatment potential requires an improved understanding of the hydraulic and biogeochemical factors that govern contaminant behavior, however detailed studies of flow through natural, tropical wetlands are scarce. We performed a tracer study using a conservative salt (potassium bromide) to examine the hydraulic behavior of a small, natural wetland in the Costa Rican humid tropics and modeled observed breakthrough curves using the 1-D advection–dispersion equation. Velocities in the wetland were extremely slow, from less than 4 m day−1 to a maximum of ~30 m day−1, and were distributed across several flowpaths, illustrating a spatial heterogeneity of flow and velocities. Modeled dispersion coefficients were also low (33 ± 33 m2 day−1). Estimated residence times suggested high potential pollutant removal capacity over a range of influent concentrations, reinforcing the environmental services provided by this and other small tropical wetlands. The study also highlighted how small variations in wetland topography and vegetation yield strong differences in transport patterns that affect transport and mixing in densely vegetated, heterogeneous wetland systems. Empirical data on the hydraulics, and resulting ecosystem functions, of small, distributed wetlands may provide support for improved conservation and management of these important ecosystems.

There is worldwide interest in conservation tillage practices because they can reduce surface runoff, and agrichemical and sediment losses from farm fields. Since these practices typically increase infiltration, their use may increase subsurface transport of water-soluble contaminants. Thus, to assess long-term environmental benefits of conservation tillage data may be needed that quantify both surface and subsurface contaminant fluxes. This study focused on the herbicide fluometuron (N,N-dimethyl-N′-[3-(trifluoromethyl)phenyl]-urea) and its soil degradate DMF (N-methyl-N′-[3-(trifluoromethyl) phenyl]-urea). Both compounds are classed as “leachable”. They were measured for 10years in surface runoff and lateral subsurface flow from paired fields located on a hill slope in the Atlantic Coastal Plain region of the southeastern USA. One group of fields was conventionally tilled incorporating all crop residues into soil prior to planting. The second was strip tilled, a common conservation tillage practice. Seven fluometuron applications were made to cotton (Gossypium hirsutum) produced in rotation with peanut (Arachis hypogea). Combined fluometuron and DMF surface and subsurface losses from the conventionally tilled fields were equivalent to 1.2% and 0.13% of fluometuron applied and 0.31% and 0.32% from the strip tilled fields. Annual surface runoff losses were significantly greater from the conventionally tilled fields while the strip tilled fields had significantly greater annual subsurface losses. Results demonstrated that shifting from conventional to conservation tillage management of farm fields in this landscape will reduce surface runoff losses of herbicides like fluometuron but subsurface losses will likely increase. The same trends can be expected in landscapes with similar soil and hydrologic properties. This should be considered when planning implementation of programs that promote conservation tillage use.