Occurrence, speciation, and controls on arsenic mobilization in the alluvial aquifer system of the Ghaghara basin, India

High concentrations of arsenic (As) in groundwater are among the long-standing environmental problems on the planet. Due to adverse impacts on the human and aquatic system, characterization and quantification of individual inorganic As species are crucial in understanding the occurrence, environmental fate, behaviour, and toxicity in natural waters. This study presents As concentration and its speciation As(III) and As(V) data, including the interrelationship with other major and trace aqueous solutes from parts of the Ghaghara basin, India. More than half (57%) of the groundwater samples exhibited elevated As concentrations (> 10 μg/L), whereas 67.4% of samples have higher As(III) values relative to As(V), signifying a potential risk of As(III) toxicity. The elevated concentration of As was associated with higher Fe, Mn, and HCO3-, especially in samples from shallow well depth. PHREEQC modeling demonstrates the presence of mineral phases such as hematite, goethite, rhodochrosite, etc. Therefore, it is inferred that the release of As from sediment particles into pore water via microbially mediated Fe/Mn oxyhydroxides, and As(V) reduction processes mainly control high As concentrations. The heavy metal pollution indices (HPI) and (HEI) values revealed heavy metal pollution in low-lying areas deposited by relatively younger sediments along the Ghaghara River. Large-scale agricultural practices, overexploitation of groundwater, and indiscriminate sewage disposal, in addition to geogenic factors, cannot be ruled out as potential contributors to As mobilization in the region. This study recommends conducting seasonal hydrogeochemical monitoring and investigating regional natural background levels of As, to precisely understand the controlling mechanistic pathways of As release.

Evaluation of physicochemical and microbiological parameters, and their correlation in Himalayan Spring Water Systems: A case study of District Kulgam of Kashmir Valley, India, Western Himalaya

Total coliforms, E. coli, and fecal streptococci are the important indicators linked to the human health. This study investigated presence of these indicator bacteria in the Himalayan springs at various locations in the district Kulgam of Kashmir valley. A total of 30 spring water samples were collected from rural, urban, and forest areas during post-melting season 2021 and pre-melting season 2022. The springs in the area originate from the alluvium deposit, Karewa, and hard rock formations. The physicochemical parameters were found within the acceptable limits. However, nitrate and phosphate were found above the permissible limit at few sites, thus indicating the presence of anthropogenic activities in the area. Majority of the samples during both the seasons were found highly loaded with total coliforms with maximum limit of greater than 180 MPN/100 ml. E. coli and fecal streptococci were found in the range of less than 1 to more than 180 MPN/100 ml. The results of Pearson correlation of physicochemical parameters with indicator bacteria showed that chemical oxygen demand, rainfall, spring discharge, nitrate, and phosphate are the main factors affecting the concentration of indicator bacteria in the spring water at each site. Principal component analysis showed the most influencing factors of water quality in most of the spring sites are total coliforms, E. coli, fecal streptococci, rainfall, discharge, and chemical oxygen demand. The results of this study showed that the spring water is unfit for drinking purpose because of high concentration of fecal indicator bacteria.

Evaluation of prognostic risk models for postoperative pulmonary complications in adult patients undergoing major abdominal surgery: a systematic review and international external validation cohort study

BACKGROUND

Stratifying risk of postoperative pulmonary complications after major abdominal surgery allows clinicians to modify risk through targeted interventions and enhanced monitoring. In this study, we aimed to identify and validate prognostic models against a new consensus definition of postoperative pulmonary complications.

METHODS

We did a systematic review and international external validation cohort study. The systematic review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched MEDLINE and Embase on March 1, 2020, for articles published in English that reported on risk prediction models for postoperative pulmonary complications following abdominal surgery. External validation of existing models was done within a prospective international cohort study of adult patients (≥18 years) undergoing major abdominal surgery. Data were collected between Jan 1, 2019, and April 30, 2019, in the UK, Ireland, and Australia. Discriminative ability and prognostic accuracy summary statistics were compared between models for the 30-day postoperative pulmonary complication rate as defined by the Standardised Endpoints in Perioperative Medicine Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC). Model performance was compared using the area under the receiver operating characteristic curve (AUROCC).

FINDINGS

In total, we identified 2903 records from our literature search; of which, 2514 (86·6%) unique records were screened, 121 (4·8%) of 2514 full texts were assessed for eligibility, and 29 unique prognostic models were identified. Nine (31·0%) of 29 models had score development reported only, 19 (65·5%) had undergone internal validation, and only four (13·8%) had been externally validated. Data to validate six eligible models were collected in the international external validation cohort study. Data from 11 591 patients were available, with an overall postoperative pulmonary complication rate of 7·8% (n=903). None of the six models showed good discrimination (defined as AUROCC ≥0·70) for identifying postoperative pulmonary complications, with the Assess Respiratory Risk in Surgical Patients in Catalonia score showing the best discrimination (AUROCC 0·700 [95% CI 0·683-0·717]).

INTERPRETATION

In the pre-COVID-19 pandemic data, variability in the risk of pulmonary complications (StEP-COMPAC definition) following major abdominal surgery was poorly described by existing prognostication tools. To improve surgical safety during the COVID-19 pandemic recovery and beyond, novel risk stratification tools are required.

FUNDING

British Journal of Surgery Society.

Hydrogeochemical and health risk assessment in and around a Ramsar-designated wetland, the Ganges River Basin, India: Implications for natural and human interactions

Wetlands are the most productive and dynamic ecosystems, which have continuously been influenced by social and economic development. As a result, the pollution of wetland surface water and groundwater in adjacent regions has become an emerging global issue that requires constant monitoring and assessment. The current study investigates the natural and anthropogenic processes that influence surface and groundwater chemistry in and around Saman wetland (a Ramsar site) in the Ganges River Basin, India. Various physicochemical parameters are analyzed, and different hydrochemical indices are utilized to evaluate surface and groundwater quality for domestic and irrigation purposes. It is observed that the waters are alkaline in nature and dominated by moderately hard to hard types. An increase in the concentration of nitrate (NO₃^-) in Saman wetland water is noted, which is possibly due to the leaching of nitrogen ions primarily from fertilizers, pesticides, animal and human waste, and wastewater drained from brick and other factories. The elevated fluoride (F^-) content in studied groundwater samples is mainly governed by geogenic processes. Furthermore, surface and groundwater chemistry are mainly controlled by weathering reaction (rock-water interaction), excluding a few wetland surface water samples that are placed outside the boomerang-shaped boundaries of Gibb's diagram, which suggests evaporated dominance. Water Quality Index (WQI) estimation suggests that around 57% of groundwater samples have poor groundwater quality for drinking purposes. Estimation of irrigation water quality indices suggests that surface water of Saman wetland is permissible for irrigation purposes; however, none of the samples have excellent and good class as per sodium (alkali) hazard. Furthermore, health risk assessment showed that NO₃^- and F^- levels in the groundwater pose noncarcinogenic health effects, preferably to children, and thus is unfit for drinking purposes. For long-term water resource management and conservation of the Saman wetland, this study suggests proper awareness, appropriate remedial measures, and regular monitoring of the surface as well as groundwater quality monitoring in the study region.

321 Surgery Induction Guidebook – an Aid to a Successful Transition

Aim

There is a 4–12% increase in mortality following the August change over in the National Health Service (NHS) UK. A well-structured induction programme is mandatory to improve both the competency and confidence of new junior doctors. This activity was designed to evaluate and improve the induction process in Pilgrim Hospital by introducing an induction guidebook. It aimed to provide a sustainable and reliable source of information to junior doctors.

Method

An initial survey in the department assessed the needs and identified the information required for the guidebook. An induction guidebook was designed and circulated during the changeover. A feedback survey was conducted after the six months of the initial Induction guidebook release, to know the usefulness of components of the induction guidebook and identify any gaps to improve the guidebook.

Results

A total of 15 participants completed the feedback survey. 47% (7) found the induction guidebook beneficial and 53.3 % (8) found it ‘slightly beneficial'. Similarly, only 1 participant (6.7%) rated the guidebook to be “of minor importance”, while 53% (8) rating it “very important” part of induction. The feedback for the contents of the book was also encouraging with suggestions.

Conclusions

The guidebook proved to be a valuable source in helping new doctors during times of transition to adjust to the local system and improve the induction process. It provided information about local guidelines, job overview, team structure, IT, useful contacts, and other relevant information. We recommend the departmental guidebook as a vital part of local departmental induction during the changeover.

Assessment of hydrogeochemical characteristics of groundwater in parts of Hindon-Yamuna interfluve region, Baghpat District, western Uttar Pradesh

The present study has been carried out to assess groundwater quality in parts of Hindon-Yamuna interfluve region of western Uttar Pradesh. Fifty-five groundwater samples were collected from hand pumps in post-monsoon 2005 and pre-monsoon 2006 period, respectively, covering an area of about 1,345 km(2). Physical and chemical parameters of groundwater such as electrical conductivity, pH, total dissolved solid, Na, K, Ca, Mg, HCO(3), Cl, and SO(4) were determined. Concentration of the chemical constituents in groundwater of the study area varies spatially and temporarily. Interpretation of analytical data of major ion chemistry helps to identify three chemical types of groundwater i.e. 'mixed', 'mixed bicarbonate' and 'alkali bicarbonate' types. The species likely to occur in groundwater of the study area are Ca-HCO(3), Mg-HCO(3), Ca-SO(4), Na-Cl, Na-SO(4), Na-HCO(3), K-Cl, and some other possible species of K, depending on its abundance. The groundwater of the study area comes under the category of moderately hard to very hard, mildly acidic to slightly alkaline in nature. There is anomalously high concentration of major ions, particularly, Na, K, SO(4), and Cl. High SO(4) and K values may be related to anthropogenic influences, rather than through some natural process. Sodium along with Cl may be added to the system through sewage pollution and leachate percolation.