Ecosystem services consideration in the remediation process for contaminated sites

In 2009, the U.S. Environmental Protection Agency's Science Advisory Board recommended activities to advance consideration of ecosystem services (ES) to enhance existing remediation and redevelopment processes in the U.S. This article examines advancements in the decade since, focusing on providing those involved in cleanup of contaminated sites a basic understanding of ES concepts and guidelines for considering ES at cleanup sites using a new, four-step transferable framework. Descriptions, including activities for site teams and case study applications of ES tools, are presented for each step: (1) identify site-specific ES; (2) quantify relevant ES; (3) examine how cleanup activities affect ES; and (4) identify, select, and implement solutions (e.g., Best Management Practices). The goal of this article is to provide site cleanup stakeholders, including project managers, contractors, and site responsible parties, with a stronger foundation and shared understanding to consider ES during the cleanup process for their given site. Anticipated outcomes include identifying ES benefits to inform management and tradeoff analyses, a reduction in unintended impacts on ES during site operations, and attention to developing a robust suite of ES relevant for site reuse.

Relation of Fractionated Atrial Potentials With the Vagal Innervation Evaluated by Extracardiac Vagal Stimulation During Cardioneuroablation

BACKGROUND

Vagal hyperactivity is directly related to several clinical conditions as reflex/functional bradyarrhythmias and vagal atrial fibrillation (AF). Cardioneuroablation provides therapeutic vagal denervation through endocardial radiofrequency ablation for these cases. The main challenges are neuromyocardium interface identification and the denervation control and validation. The finding that the AF-Nest (AFN) ablation eliminates the atropine response and decreases RR variability suggests that they are related to the vagal innervation.

METHOD

Prospective, controlled, longitudinal, nonrandomized study enrolling 62 patients in 2 groups: AFN group (AFN group 32 patients) with functional or reflex bradyarrhythmias or vagal AF treated with AFN ablation and a control group (30 patients) with anomalous bundles, ventricular premature beats, atrial flutter, atrioventricular nodal reentry, and atrial tachycardia, treated with conventional ablation (non-AFN ablation). In AFN group, ablation delivered at AFN detected by fragmentation/fractionation of the endocardial electrograms and by 3-dimensional anatomic location of the ganglionated plexus. Vagal response was evaluated before, during, and postablation by 5 s noncontact vagal stimulation at the jugular foramen, through the internal jugular veins (extracardiac vagal stimulation [ECVS]), analyzing 15 s mean heart rate, longest RR, pauses, and atrioventricular block. All patients had current guidelines arrhythmia ablation indication.

RESULTS

Preablation ECVS induced sinus pauses, asystole, and transient atrioventricular block in both groups showing a strong vagal response (P=0.96). Postablation ECVS in the AFN group showed complete abolishment of the cardiac vagal response in all cases (pre/postablation ECVS=P<0.0001), demonstrating robust vagal denervation. However, in the control group, vagal response remained practically unchanged postablation (P=0.35), showing that non-AFN ablation promotes no significant denervation.

CONCLUSIONS

AFN ablation causes significant vagal denervation. Non-AFN ablation causes no significant vagal denervation. These results suggest that AFNs are intrinsically related to vagal innervation. ECVS was fundamental to stepwise vagal denervation validation during cardioneuroablation. Visual Overview A visual overview is available for this article.

Comparison of international approaches to sustainable remediation

Since mid-to-late 2000s growing interest for sustainable remediation has emerged in initiatives from several international and national organisations as well as other initiatives from networks and forums. This reflects a realisation that risk-management activities can about bring environmental, social, and economic impacts (positive or negative) in addition to achieving risk-based remediation goals. These ideas have begun to develop as a new discipline of "sustainable remediation". The various initiatives have now published a number of frameworks, standards, white papers, road maps and operative guidelines. The similarities and differences in the approaches by these outputs and general trends have been identified. The comparison is based on a set of criteria developed in discussion with members of these various initiatives, and identifies a range of similarities between their publications. Overall the comparison demonstrates a high level of consensus across definitions and principles, which leads to the conclusion that there is a shared understanding of what sustainable remediation is both across countries and stakeholder groups. Publications do differ in points of detail, in particular about the operational aspects of sustainable remediation assessment. These differences likely result from differences in context and legal framework. As this analysis was carried out its findings were debated with members of the various international initiatives, many of whom have been included as authors. Hence the outcomes described in this paper can be seen as the result of a sort of multi-level debate among international experts (authors) and so can offer a starting point to new sustainable remediation initiatives (for example in other countries) that aim to start developing their own documents.