Recreational drug-use as an urban source of nitrous oxide

N2O is a potent greenhouse gas which also contributes to depletion of stratospheric ozone. Its primary sources are from natural and agricultural soils and from the ocean. However, other minor sources exist, including industrial processes, combustion processes in the power generation sector and road transport. Very few atmospheric measurements of these minor sources of N2O exist in the urban environment, particularly in the UK. Nonetheless, they are essential in understanding anthropogenic emissions of N2O. A custom-built automated sampling system was used to make high-frequency measurements of N2O, along with SF6, CO and H2 at an urban site in the city of Bristol, United Kingdom (UK), from 3rd November 2019 to 26th November 2021. These time-series data provide an insight into urban N2O mole fractions, diurnal cycles, and possible sources of N2O during a period of time affected by the COVID-19 pandemic. The data show a pattern of elevated N2O mole fractions during the late evening and early morning hours on weekends, with no significant correlations with other measured species, indicating the apparent use of N2O as a recreational drug. The National Atmospheric Emissions Inventory (NAEI) reports UK emissions for recreational N2O drug use of 12-14 tonnes between 2012 and 2020. We derived a much larger estimate of 89-954 tonnes for the year 2020 using revised estimates of the size of canisters used, the mass of N2O in each canister and the number of times the drug is used at each sitting. © 2023 The Author(s).

Under 40s one stop clinic run by breast surgeons who can do ultrasound helps manage capacity and reduces waiting time. A possible model for training of future breast surgeons

Background: Breast services are heavily dependent on radiology support for diagnostic tests. Breast ultrasound is the preferred imaging tool in the under 40s. The covid pandemic has resulted in a huge increase in waiting times for breast patients throughout the country. Additionally, there is a shortage of radiologists to support screening and breast services. Surgeons who are experienced in breast ultrasound are able to reduce the workload of radiologists and reduce waiting times. We present our results of one stop under 40s clinic by breast surgeons who do ultrasound and the impact it has had on waiting times within our unit. Method: Retrospective study of patients seen as part of the weekend waiting list initiative during May-July 2021. Clinics were built every weekend (Sat and Sun) in the absence of radiology support. Results: 899 patients of all ages were waiting to be seen in one stop clinics. A total of 11 under 40s one stop clinics were coordinated during this period when there was no radiology support. 197 patients were seen in these clinics by two surgeons proficient in performing ultrasound thereby reducing the waiting list by 22%. There are 8 consultant surgeons within our unit. Conclusion: The above study highlights the immense usefulness of ultrasound as a clinical adjunct to breast surgeons. Given the pressures that continue to occur in the light of the pandemic, it is imperative that our present generation of breast surgical trainees learn to perform ultrasound.