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

ESTRATEGIAS PARA DISMINUIR LA CONTAMINACION POR ORGANISMOS BACTERIANOS PATOGENOS, EN LA FUENTE ABASTECEDORA DE AGUA DEL ACUEDUCTO DE LA CIUDAD DE PEREIRA.

Otún river is the main source of water supply for Pereira and Dosquebradas cities. Over the last forty years agricultural and productive developments have increased the rural population over its basin upstream of the derivation of aqueduct. Simultaneously water quality has been affected over the years, especially, bacteriological aspects. In this research every cause of bacteriological water quality detriment was assessed in order to know its influence and to make priorities for prevention and control. The results shown that agricultural practices, solid waste and waste water from pig and hen farms and waste water from small villages are the main sources of bacteriological pollution. Strategies for prevention and control of contamination were analyzed and formulated from the point of view of cleaner production.El río Otún es la principal fuente de abastecimiento de agua potable para los municipios de Pereira y Dosquebradas, sin embargo en los últimos 40 años una serie de desarrollos agrícolas y pecuarios han incrementado, tanto la frontera agrícola como la población localizada aguas arriba de la bocatoma del acueducto. En forma simultánea y conforme se ha dado el desarrollo agropecuario y poblacional, la calidad del agua, especialmente manifestada con los indicadores de contaminación bacteriológica, se ha deteriorado. En esta investigación, se analizaron cada una de las posibles causas de contaminación bacteriológica a fin de determinar su influencia o aporte al río y establecer una serie de estrategias para su prevención y control. Los resultados indican que las principales causas de deterioro, están asociadas a inadecuadas prácticas agrícolas y a vertimientos de residuos sólidos y líquidos a los diferentes cuerpos de agua, procedentes de granjas avícolas y porcícolas, de asentamientos humanos, así como de cultivos asociados a abonos no estabilizados localizados en dicha área

Identificación automática de transformación en el bosque seco tropical colombiano usando GMM y UBM-GMM

Today, machine learning methods have become a powerful tool to help curb the effects of global warming by solving ecological questions. In particular, the Colombian Tropical Dry Forest (TDF) is an important ecosystem that is currently under threat due to deforestation generated by cattle, mining, and urban development since colonial times. One of the urgent challenges in this area is to understand the threatened ecosystems landscape transformation and forest degradation. Traditionally, environmental conservation experts measure these changes using transformation levels (high, medium, low). These levels have been obtained through direct observation, counting species, and measures of spatial variation through the time. Therefore, these methods are invasive to the study landscapes and require large amounts of time analysis. A proficient alternative to classical methods is the passive acoustic monitoring, as they are less invasive to the environment, avoid seeing the difficulty of species from isolated individuals, and help reduce the time of researchers at the sites. Even though too much data is generated, and computational tools have been required for their analysis. This paper proposes a new method to automatically identify the transformation in the Colombian TDF. The method is based on Gaussian Mixture Models (GMM) and Universal Background Model (UBM). In addition, it includes an acoustic indices analysis to select the most informative variables. The GMM proposal was tested in two local sites (La Guajira and Bolivar regions) and achieved an accuracy of 93% and 89% for each one, and it was obtained 84% with the general UBM model.Hoy, los métodos de aprendizaje automático se han convertido en una herramienta para ayudar a frenar los efectos del calentamiento global, al resolver cuestiones ecológicas. En particular, el bosque seco tropical (BST) de Colombia se encuentra actualmente amenazado por la deforestación generada, desde la época colonial, por la ganadería, la minería y el desarrollo urbano. Uno de los desafíos urgentes en esta área es comprender la transformacion y degradación de los bosques. Tradicionalmente, los cambios de los ecosistemas se miden por varios niveles de transformación (alto, medio, bajo). Estos se obtienen a través de observación directa, recuento de especies y medidas de variación espacial a lo largo del tiempo. Por ende, estos métodos son invasivos y requieren de largos lapsos de observación en los lugares de estudio. Una alternativa eficaz a los métodos clásicos es el monitoreo acústico pasivo, que es menos invasivo, ya que evita el aislamiento de las especies y reduce el tiempo de los investigadores en los sitios. Sin embargo, implica la generación de múltiples datos y la necesidad de herramientas computacionales destinadas al análisis de las grabaciones. Este trabajo propone un método para identificar automáticamente la transformación del BST mediante grabaciones acústicas, aplicando dos modelos de clasificación: Gaussian Mixture Models (GMM), por cada región estudiada, y Universal Background Model (UBM), para un modelo general. Además, contiene un análisis de índices acústicos, con el fin de detectar los más representativos para las transformaciones del BST. Nuestra propuesta de GMM alcanzó una precisión de 93% y 89% para las regiones de La Guajira y Bolívar. El modelo general UBM logró 84% de precisión

7.Econ.concorrenza e regolazione_AeGI 2015_2016_2 PP

<div><p>Black Sigatoka or black leaf streak disease, caused by the Dothideomycete fungus <i>Pseudocercospora fijiensis</i> (previously: <i>Mycosphaerella fijiensis</i>), is the most significant foliar disease of banana worldwide. Due to the lack of effective host resistance, management of this disease requires frequent fungicide applications, which greatly increase the economic and environmental costs to produce banana. Weekly applications in most banana plantations lead to rapid evolution of fungicide-resistant strains within populations causing disease-control failures throughout the world. Given its extremely high economic importance, two strains of <i>P</i>. <i>fijiensis</i> were sequenced and assembled with the aid of a new genetic linkage map. The 74-Mb genome of <i>P</i>. <i>fijiensis</i> is massively expanded by LTR retrotransposons, making it the largest genome within the Dothideomycetes. Melting-curve assays suggest that the genomes of two closely related members of the Sigatoka disease complex, <i>P</i>. <i>eumusae</i> and <i>P</i>. <i>musae</i>, also are expanded. Electrophoretic karyotyping and analyses of molecular markers in <i>P</i>. <i>fijiensis</i> field populations showed chromosome-length polymorphisms and high genetic diversity. Genetic differentiation was also detected using neutral markers, suggesting strong selection with limited gene flow at the studied geographic scale. Frequencies of fungicide resistance in fungicide-treated plantations were much higher than those in untreated wild-type <i>P</i>. <i>fijiensis</i> populations. A homologue of the <i>Cladosporium fulvum Avr4</i> effector, <i>PfAvr4</i>, was identified in the <i>P</i>. <i>fijiensis</i> genome. Infiltration of the purified PfAVR4 protein into leaves of the resistant banana variety Calcutta 4 resulted in a hypersensitive-like response. This result suggests that Calcutta 4 could carry an unknown resistance gene recognizing PfAVR4. Besides adding to our understanding of the overall Dothideomycete genome structures, the <i>P</i>. <i>fijiensis</i> genome will aid in developing fungicide treatment schedules to combat this pathogen and in improving the efficiency of banana breeding programs.</p></div

Comparison of the amount of repeat-induced point mutation (RIP) between AT-rich blocks and more GC-rich regions of the <i>Pseudocercospora fijiensis</i> genome as measured by the RIP index (CpA+TpG)/(ApC+GpT).

<p>(A) AT-rich blocks have a lower RIP index indicating a depletion of RIP-susceptible sites due to a higher frequency of RIP compared to (B) an AT-poor region (higher GC) of the genome, which has a higher RIP index reflecting very little RIP. Four AT-rich blocks are shown along with one AT-poor region for comparison. Length of each block in kilobases is shown along the x-axis and the RIP index (CpA+TpG)/(ApC+GpT) is shown on the y-axis.</p

Comparison of repeat classes among <i>Zymoseptoria tritici</i>, the only Dothideomycete with a completely sequenced genome, <i>Pseudocercospora fijiensis</i> and <i>Cladosporium fulvum</i>, the only other Dothideomycete known to have a transposon-expanded genome.

<p>Comparison of repeat classes among <i>Zymoseptoria tritici</i>, the only Dothideomycete with a completely sequenced genome, <i>Pseudocercospora fijiensis</i> and <i>Cladosporium fulvum</i>, the only other Dothideomycete known to have a transposon-expanded genome.</p

Infiltration of purified protein of the putative effector gene <i>PfAvr4</i> from <i>Pseudocercospora fijiensis</i> into leaves of banana and tomato.

<p>A: Infiltrations into leaves of resistant and susceptible banana varieties. B: Infiltrations into leaves of tomato with or without the <i>Cf4</i> resistance gene known to interact with PfAVR4. Experiments were done with crude fermentor product and concentrated or diluted product. Fermentor medium alone and water were used as controls.</p

Electrophoretic karyotypes of two strains of <i>Pseudocercospora fijiensis</i>.

<p>A) Bands separated with conditions for small chromosomes. Lane 1, chromosomes from <i>Saccharomyces cerevisiae</i> as high-molecular-weight (HMW) marker; lane 2, strain CIRAD86; lane 3, strain E22. B) Bands separated under conditions to resolve medium and large chromosomes. Lane 1, chromosomes from <i>Schizosaccharomyces pombe</i> as HMW marker for large chromosomes; lane 2, strain CIRAD86; lane 3, strain E22; lane 4, chromosomes from <i>Hansenula wingei</i> as HMW marker for medium chromosomes in size. Marker sizes are in Kb.</p