Aim Conservation and land-use planning require accurate maps of patterns in species composition and an understanding of the factors that control them. Substantial doubt exists, however, about the existence and determinants of largearea floristic divisions in Amazonia. Here we ask whether Amazonian forests are partitioned into broad-scale floristic units on the basis of geological formations and their edaphic properties.Location Western and central Amazonia.Methods We used Landsat imagery and Shuttle Radar Topography Mission (SRTM) digital elevation data to identify a possible floristic and geological discontinuity of over 300 km in northern Peru. We then used plant inventories and soil sampling to document changes in species composition and soil properties across this boundary. Data were obtained from 138 sites distributed along more than 450 km of road and river. On the basis of our findings, we used broad-scale Landsat and SRTM mosaics to identify similar patterns across western and central Amazonia.Results The discontinuity identified in Landsat and SRTM data corresponded to a 15-fold change in soil cation concentrations and an almost total change in plant species composition. This discontinuity appears to be caused by the widespread removal of cation-poor surface sediments by river incision to expose cation-rich sediments beneath. Examination of broad-scale Landsat and SRTM mosaics indicated that equivalent processes have generated a north-south discontinuity of over 1500 km in western Brazil. Due to similarities with our study area, we suggest that this discontinuity represents a chemical and ecological limit between western and central Amazonia.Main conclusions Our findings suggest that Amazonian forests are partitioned into large-area units on the basis of geological formations and their edaphic properties. The evolution of these units through geological time may provide a general mechanism for biotic diversification in Amazonia. These compositional units, moreover, may correspond to broad-scale functional units. The existence of large-area compositional and functional units would suggest that protected-area, carbon sequestration, and other land-use strategies in Amazonia be implemented on a region-by-region basis. The methods described here can be used to map these patterns, and thus enable effective conservation and management of Amazonian forests.

Peri-operative SARS-CoV-2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS-CoV-2 infection. This international, multicentre, prospective cohort study included patients undergoing elective or emergency surgery during October 2020. Surgical patients with pre-operative SARS-CoV-2 infection were compared with those without previous SARS-CoV-2 infection. The primary outcome measure was 30-day postoperative mortality. Logistic regression models were used to calculate adjusted 30-day mortality rates stratified by time from diagnosis of SARS-CoV-2 infection to surgery. Among 140,231 patients (116 countries), 3127 patients (2.2%) had a pre-operative SARS-CoV-2 diagnosis. Adjusted 30-day mortality in patients without SARS-CoV-2 infection was 1.5% (95%CI 1.4-1.5). In patients with a pre-operative SARS-CoV-2 diagnosis, mortality was increased in patients having surgery within 0-2 weeks, 3-4 weeks and 5-6 weeks of the diagnosis (odds ratio (95%CI) 4.1 (3.3-4.8), 3.9 (2.6-5.1) and 3.6 (2.0-5.2), respectively). Surgery performed ≥ 7 weeks after SARS-CoV-2 diagnosis was associated with a similar mortality risk to baseline (odds ratio (95%CI) 1.5 (0.9-2.1)). After a ≥ 7 week delay in undertaking surgery following SARS-CoV-2 infection, patients with ongoing symptoms had a higher mortality than patients whose symptoms had resolved or who had been asymptomatic (6.0% (95%CI 3.2-8.7) vs. 2.4% (95%CI 1.4-3.4) vs. 1.3% (95%CI 0.6-2.0), respectively). Where possible, surgery should be delayed for at least 7 weeks following SARS-CoV-2 infection. Patients with ongoing symptoms ≥ 7 weeks from diagnosis may benefit from further delay.

Studies in western Amazonian forests have found that similarities in soil cation concentration and texture explain floristic similarities between sites, when these are measured using trees, pteridophytes or Melastomataceae. However, it is not known to what extent the three plant groups react to the same soil characteristics, because tree studies have almost always been conducted in different areas than studies on the understorey plant groups. We made inventories in 23 sites representing non-inundated rain forests on clayey to loamy soil in three regions of western Amazonia. Significant Mantel correlations between the floristic patterns of trees and pteridophytes were found in all three regions when floristic differences were measured with species presence–absence data. When species abundance data were used, and when the floristic patterns of trees and Melastomataceae were compared, significant correlations were found in one or two regions. Mantel correlations between plant groups were highest in the two regions where the observed variation in soil characteristics was largest. In all regions, the same soil variables emerged with significant Mantel correlations with trees, pteridophytes and Melastomataceae. Soil calcium and magnesium were most frequently retained in the models of multiple regression on distance matrices. On average, soil differences explained 50% of the variation in floristic differences (range = 14–84%), and geographical distances explained 16% (range = 0–64%). Our results demonstrate that beta diversities of the three plant groups are highly correlated, and that much of this congruence is explained by similar reactions to soil variation. These results support the idea that pteridophytes, and to a lesser degree Melastomataceae, can be used as indicators of general floristic and edaphic patterns in Amazonian rain forests. Since understorey plants are much quicker to inventory than trees, this would make it possible to recognize and map floristic patterns over huge areas of lowland Amazonia within a reasonable time.