Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Nitrate Reductase Activity in Eucalyptus urophylla and Khaya senegalensis Seedlings: Optimization of the in vivo Assay

Nitrate assimilation in the plant cell is mainly regulated by the enzyme nitrate reductase (EC 1.6.6.1), which catalyzes the nitrate to nitrite reduction. Nitrate reductase activity (NRA) is measured at the major nitrate reduction site, which can be the root or shoot, depending on the species. The in vivo assay has often been used for NRA measurement, and protocol also usually varies with the species. The goals of this study were: (1) to identify the major nitrate reduction site in seedlings of two tree species, Eucalyptus urophylla and Khaya senegalensis, and (2) to optimize the in vivo nitrate reductase assay at the major nitrate reduction site in these species. Healthy seedlings aged 180 and 160 days, respectively, were selected for NRA measurement in fully expanded leaves and main root. After identifying the main nitrate reduction site of each species, the effects of variations in temperature, nitrate concentration and pH in the incubation medium were assessed. The results showed that the leaf and the root are the major nitrate reduction site of Eucalyptus urophylla and Khaya senegalensis, respectively. The optimal conditions for the in vivo assay in the leaf were 35 °C, $KNO_3$ 100 mM, and pH 7.0, whereas for the root they were 30 °C, $KNO_3$ 100 mM, and pH 7.5

Assessment of clinical characteristics and viral load in individuals infected by Delta and Omicron variants of SARS-CoV-2

In late 2021, a new variant of SARS-CoV-2 called Omicron emerged, replacing Delta worldwide. Although it has been associated with a lower risk of hospitalization and severe forms of COVID-19, there is little evidence of its relationship with specific symptoms and viral load. The aim of this study was to verify the relationship between Delta and Omicron variants of concern, viral load, and the occurrence of symptoms in individuals with COVID-19. Nasopharyngeal swab samples were collected and sequenced from patients with COVID-19 from the Northeast Region of Brazil between August 2021 and March 2022. The results showed a gradual replacement of the Delta variant by the Omicron variant during the study period. A total of 316 samples (157 Delta and 159 Omicron) were included. There was a higher prevalence of symptoms in Delta-infected individuals, such as coryza, olfactory and taste disturbances, headache, and myalgia. There was no association between viral load and the variants analyzed. The results reported here contribute to the understanding of the symptoms associated with the Delta and Omicron variants in individuals affected by COVID-19

PRODUÇÃO DE RECURSOS DIDÁTICOS NA EXTENSÃO: PROPOSTAS DE ENSINO DE CIÊNCIAS USANDO INSTRUMENTOS DIDÁTICOS

A obra Produção de Recursos Didáticos na Extensão: Propostas de Ensino de Ciências Usando Instrumentos Didáticos é produto de pesquisas e trabalhos desenvolvidos no curso de Licenciatura em Biologia da Universidade Federal de Tocantins (UFT), Câmpus de Araguaína, através dos projetos de extensão Futuros Cientistas – Vêm para a Biologia (Coordenadora Lidianne Salvatierra) e Feira de Ciências do Estado do Tocantins (Coordenador Gecilane Ferreira) que possuem como objetivos centrais e confluentes a aproximação de alunos e professores da Educação Básica com a comunidade acadêmica, o fomento do senso de investigação científica de alunos do Ensino Fundamental e Ensino Médio, e apresentação e captação de futuros acadêmicos para o curso de Biologia.Ambos os projetos de extensão são desenvolvidos no âmbito do curso de Biologia com a participação de escolas públicas de Araguaína e demais municípios próximos, e consiste no desenvolvimento de dinâmicas de simulação de pesquisa, onde estudantes da rede básica aprendem mais sobre o curso de Biologia e são convidados a participarem ativamente dos eventos da universidade ainda durante a Educação Básica. Os projetos são de caráter intermitente a fim de contribuir para a diminuição da distância entre a comunidade externa e interna.A presente obra foi pensada em duas partes com objetivos distintos, porém interligados. Uma parte (Parte I) foca nesta obra como um produto acadêmico a partir de projetos de extensão na forma de um material de apoio aos professores de Ciências e Biologia que necessitam criar seus próprios recursos didáticos, e é composta por uma coletânea de comunicações curtas de planejamentos de modelos didáticos de baixo custo. E a segunda parte (Parte II) apresenta artigos completos que abordam a utilização de maquetes didáticas no ensino a partir de diferentes pontos de vistas e outros relatos de experiências provenientes das ações dos projetos de extensão. A seguir cada parte é detalhada, comentada e contextualizada:A Parte I – Coletânea de Comunicações Curtas sobre Modelos Didáticos de Invertebrados apresenta uma série de comunicações curtas sobre o processo de planejamento e confecção de maquetes didáticas de baixo custo com foco no ensino de Zoologia dentro das habilidades EM13CNT202 da Base Nacional Comum Curricular. Todas as comunicações foram elaboradas a fim de que professores e alunos possam utilizar as ideias apresentadas aqui e replicá-las em suas instituições de ensino. Os extensionistas e demais alunos do curso foram incentivados a utilizarem materiaisrecicláveis ou com o menor custo possível sempre pensando na realidade socioeconômica da maioria dos estudantes da rede pública brasileira.A Parte II – Coletânea de Artigos sobre o Uso de Modelos Didáticos reuni seis artigos completos que foram produzidos a partir das experiências promovidas com o desenvolvimento dos projetos de extensão no âmbito da Universidade Federal do Tocantins em colaboração com a comunidade externa. Os artigos possuem caráter de investigação científica sobre o uso de modelos didáticos e também de relato de experiência

Sparsentan in patients with IgA nephropathy: a prespecified interim analysis from a randomised, double-blind, active-controlled clinical trial

Background: Sparsentan is a novel, non-immunosuppressive, single-molecule, dual endothelin and angiotensin receptor antagonist being examined in an ongoing phase 3 trial in adults with IgA nephropathy. We report the prespecified interim analysis of the primary proteinuria efficacy endpoint, and safety. Methods: PROTECT is an international, randomised, double-blind, active-controlled study, being conducted in 134 clinical practice sites in 18 countries. The study examines sparsentan versus irbesartan in adults (aged ≥18 years) with biopsy-proven IgA nephropathy and proteinuria of 1·0 g/day or higher despite maximised renin-angiotensin system inhibitor treatment for at least 12 weeks. Participants were randomly assigned in a 1:1 ratio to receive sparsentan 400 mg once daily or irbesartan 300 mg once daily, stratified by estimated glomerular filtration rate at screening (30 to 1·75 g/day). The primary efficacy endpoint was change from baseline to week 36 in urine protein-creatinine ratio based on a 24-h urine sample, assessed using mixed model repeated measures. Treatment-emergent adverse events (TEAEs) were safety endpoints. All endpoints were examined in all participants who received at least one dose of randomised treatment. The study is ongoing and is registered with ClinicalTrials.gov, NCT03762850. Findings: Between Dec 20, 2018, and May 26, 2021, 404 participants were randomly assigned to sparsentan (n=202) or irbesartan (n=202) and received treatment. At week 36, the geometric least squares mean percent change from baseline in urine protein-creatinine ratio was statistically significantly greater in the sparsentan group (-49·8%) than the irbesartan group (-15·1%), resulting in a between-group relative reduction of 41% (least squares mean ratio=0·59; 95% CI 0·51-0·69; p<0·0001). TEAEs with sparsentan were similar to irbesartan. There were no cases of severe oedema, heart failure, hepatotoxicity, or oedema-related discontinuations. Bodyweight changes from baseline were not different between the sparsentan and irbesartan groups. Interpretation: Once-daily treatment with sparsentan produced meaningful reduction in proteinuria compared with irbesartan in adults with IgA nephropathy. Safety of sparsentan was similar to irbesartan. Future analyses after completion of the 2-year double-blind period will show whether these beneficial effects translate into a long-term nephroprotective potential of sparsentan. Funding: Travere Therapeutics

Characterisation of microbial attack on archaeological bone

As part of an EU funded project to investigate the factors influencing bone preservation in the archaeological record, more than 250 bones from 41 archaeological sites in five countries spanning four climatic regions were studied for diagenetic alteration. Sites were selected to cover a range of environmental conditions and archaeological contexts. Microscopic and physical (mercury intrusion porosimetry) analyses of these bones revealed that the majority (68%) had suffered microbial attack. Furthermore, significant differences were found between animal and human bone in both the state of preservation and the type of microbial attack present. These differences in preservation might result from differences in early taphonomy of the bones. © 2003 Elsevier Science Ltd. All rights reserved

Growing knowledge: an overview of Seed Plant diversity in Brazil

Abstract An updated inventory of Brazilian seed plants is presented and offers important insights into the country's biodiversity. This work started in 2010, with the publication of the Plants and Fungi Catalogue, and has been updated since by more than 430 specialists working online. Brazil is home to 32,086 native Angiosperms and 23 native Gymnosperms, showing an increase of 3% in its species richness in relation to 2010. The Amazon Rainforest is the richest Brazilian biome for Gymnosperms, while the Atlantic Rainforest is the richest one for Angiosperms. There was a considerable increment in the number of species and endemism rates for biomes, except for the Amazon that showed a decrease of 2.5% of recorded endemics. However, well over half of Brazillian seed plant species (57.4%) is endemic to this territory. The proportion of life-forms varies among different biomes: trees are more expressive in the Amazon and Atlantic Rainforest biomes while herbs predominate in the Pampa, and lianas are more expressive in the Amazon, Atlantic Rainforest, and Pantanal. This compilation serves not only to quantify Brazilian biodiversity, but also to highlight areas where there information is lacking and to provide a framework for the challenge faced in conserving Brazil's unique and diverse flora