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

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

Rising rural body-mass index is the main driver of the global obesity epidemic in adults

Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities 1,2 . This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity 3�6 . Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55 of the global rise in mean BMI from 1985 to 2017�and more than 80 in some low- and middle-income regions�was due to increases in BMI in rural areas. This large contribution stems from the fact that, with the exception of women in sub-Saharan Africa, BMI is increasing at the same rate or faster in rural areas than in cities in low- and middle-income regions. These trends have in turn resulted in a closing�and in some countries reversal�of the gap in BMI between urban and rural areas in low- and middle-income countries, especially for women. In high-income and industrialized countries, we noted a persistently higher rural BMI, especially for women. There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories. © 2019, The Author(s)

Zoogéographie infra-spécifique de la Mer Méditerranée : analyse des données génétiques populationnelles sur seize espèces atlanto-méditerranéennes (poissons et invertébrés)

International audienceThe faunal relationships of the Atlantic and the Mediterranean have been affected by tectonic change in the Miocene, by climate change in the Pleistocene and by hydrological discontinuity. We use a population genetics approach to the biogeography of the Mediterranean marine fauna, in particular to describe the level of recent or present-day exchanges with the Atlantic. The level of genetic differences between populations was estimated from published and unpublished data on sixteen species from the northeastern Atlantic and the Mediterranean. For a majority of species, either tropical or subtropical or boreal fishes, or coastal invertebrates, a moderately-strong to strong genetic cline across the Gibraltar strait area was observed. Such a pattern was also observed in a proportion of species across the siculo-tunisian strait. In a limited number of cases, the geographic patterns of population genetic structure however conformed with the expectations from an isolation-by-distance model. The molecular phylogeographic approach in a boreal species, the flounder Platichthys flesus, led to the inference of the historical movements of colonisation and geographic isolation of the populations. A similar approach in a tropical species (the Spanish sardine Sardinella aurita) and a cosmopolitan species (the grey mullet Mugil cephalus) revealed close genetic relationships between Mediterranean and tropical eastern-Atlantic populations. We analyse the possible implications of these findings to the systematics of the Mediterranean populations and we speculate about the future of boreal species vis-à-vis the present climate change. We debate on various hypotheses for the maintaining of abrupt genetic clines in the marine environment.Les relations faunistiques entre l'Atlantique et la Méditerranée sont complexes, affectées par les bouleversements tectoniques du Miocène, les vicissitudes climatiques du Pleistocène et la dis-continuité des régimes hydrologiques. Nous utilisons l'approche génétique infra-spécifique pour aborder la biogéographie de la faune marine méditerranéenne et en particulier pour décrire le niveau des échanges récents ou actuels avec l'Atlantique. Les taux de différenciation génétique entre populations ont été estimés à partir des données de la littérature ou de données non publiées sur seize espèces de l'Atlantique nord-est et de la Méditerranée. Ceux-ci révèlent un gradient génétique très fort, voire une quasi-absence de flux génique de part et d'autre de la région de Gibraltar chez une majorité d'espèces, qu'il s'agisse de poissons tropicaux, subtropicaux ou boréaux, ou d'invertébrés côtiers. Une telle situation est également observée, pour une proportion des espèces, de part et d'autre du seuil siculo-tunisien. Dans un petit nombre de cas, la structure géographique paraît cependant conforme aux at-tendus du modèle d'isolement par la distance. La phylogéographie moléculaire du flet Platichthys flesus permet d'inférer la séquence des mouvements de colonisation et des isolements géographiques des populations chez une espèce à affinités boréales. Une approche similaire est utilisée chez une espèce tropicale (la sardinelle ronde Sardinella aurita) et une espèce cosmopolite (le mulet cabot Mugil cephalus), qui révèle des affinités entre les populations méditerranéennes et celles de l'Atlantique tropical est. Nous analysons les implications possibles pour la systématique des populations méditerranéennes et spéculons sur le devenir des populations de certaines espèces à affinités boréales vis-à-vis du réchauffement climatique actuel. Nous engageons une réflexion sur les hypothèses du maintien des différences génétiques entre populations de part et d'autre des zones de transition en milieu marin

The European sea bass: a key marine fish model in the wild and in aquaculture

International audienceThe European sea bass (Dicentrarchus labrax L.) is a marine fish of key economic and cultural importance in Europe. It is now more an aquaculture than a fisheries species (>96% of the production in 2016), although modern rearing techniques date back only from the late 1980s. It also has high interest for evolutionary studies, as it is composed of two semispecies (Atlantic and Mediterranean lineages) that have come into secondary contact following the last glaciation. Based on quantitative genetics studies of most traits of interest over the past 10-15 years, selective breeding programs are now applied to this species, which is at the beginning of its domestication process. The availability of a good quality reference genome has accelerated the development of new genomic resources, including SNP arrays that will enable genomic selection to improve genetic gain. There is a need to improve feed efficiency, both for economic and environmental reasons, but this will require novel phenotyping approaches. Further developments will likely focus on the understanding of genotype-by-environment interactions, which will be important both for efficient breeding of farmed stocks and for improving knowledge of the evolution of natural populations. At the interface between both, the domestication process must be better understood to improve production and also to fully evaluate the possible impact of aquaculture escapees on wild populations. The latter is an important question for all large-scale aquaculture productions

Current strategies for the assessment and evaluation of genetic diversity in chicken resources

Chicken genetic resources comprise a wide range of breeds and populations including red jungle fowl (the assumed progenitor of all domestic breeds), native and fancy breeds, middle level food producers, industrial stocks and specialised lines. Based on the suggestion that the more distant a breed or population is the more likely it is to carry unique genetic features, the assessment of genetic distances by means of molecular marker information may provide useful information for initial evaluation of chicken genetic resources. During the last two decades several molecular marker classes have become available. Variable numbers of tandem repeat loci, in particular microsatellites, have been successfully used in chicken diversity studies. Genetic diversity measures using the highly polymorphic variable number of tandem repeat lociyield reliable and accurate information for the study of genetic relationships between chicken populations. First results of the European project on chicken biodiversity (AVIANDIV) obtained from microsatellite typing in DNA pools of 51 diverse chicken breeds showed that jungle fowl populations, traditional unselected breeds and broiler lines appear to be widely heterogeneous populations that may include a large portion of the genetic diversity of the tested breeds. In contrast, highly selected strains (layers and experimental lines) are characterised by a lower polymorphism. They behave as outliers from the set of breeds sampled. Single nucleotide polymorphism is a new and very promising molecular marker system which offers opportunities to assess the genetic diversity in farm animal species differently by investigating the mode and extent of changes in certain positions in the genome

Strategies to reengage patients lost to follow up in HIV care in high income countries, a scoping review

Background: Despite remarkable achievements in antiretroviral therapy (ART), losses to follow-up (LTFU) might prevent the long-term success of HIV treatment and might delay the achievement of the 90-90-90 objectives. This scoping review is aimed at the description and analysis of the strategies used in high-income countries to reengage LTFU in HIV care, their implementation and impact. Methods: A scoping review was done following Arksey & O'Malley's methodological framework and recommendations from Joanna Briggs Institute. Peer reviewed articles were searched for in Pubmed, Scopus and Web of Science; and grey literature was searched for in Google and other sources of information. Documents were charted according to the information presented on LTFU, the reengagement procedures used in HIV units in high-income countries, published during the last 15 years. In addition, bibliographies of chosen articles were reviewed for additional articles. Results: Twenty-eight documents were finally included, over 80% of them published in the United States later than 2015. Database searches, phone calls and/or mail contacts were the most common strategies used to locate and track LTFU, while motivational interviews and strengths-based techniques were used most often during reengagement visits. Outcomes like tracing activities efficacy, rates of reengagement and viral load reduction were reported as outcome measures. Conclusions: This review shows a recent and growing trend in developing and implementing patient reengagement strategies in HIV care. However, most of these strategies have been implemented in the United States and little information is available for other high-income countries. The procedures used to trace and contact LTFU are similar across reviewed studies, but their impact and sustainability are widely different depending on the country studied

Development of microsatellite markers for the orange coral Astroides calycularis (Scleractinia, Dendrophylliidae). Permanent Genetic Resources added to Molecular Ecology Resources Database 1 August 2009–30 September 2009

5 páginas, 2 tablas.-- Grupo de trabajo: Molecular Ecology Resources Primer Development Consortium.-- et al.[EN] This adaptation text reproduces chapter III of the dissertation “Results”: Estudio genético de la estructura poblacional y conectividad de dos corales endémicos del Mediterráneo: Astroides calycularis (Pallas, 1766) y Cladocora caespitosa (Linnaeus, 1767)= Genetic assessment of population structure and connectivity in two endemic Mediterranean corals: Astroides calycularis (Pallas, 1766) and Cladocora caespitosa (Linnaeus, 1767), of P. Casado-Amezúa (2012). http://hdl.handle.net/10261/134913[ES] Este artículo es una adaptación del capítulo III de “Resultados” de la tesis doctoral: Estudio genético de la estructura poblacional y conectividad de dos corales endémicos del Mediterráneo: Astroides calycularis (Pallas, 1766) y Cladocora caespitosa (Linnaeus, 1767)= Genetic assessment of population structure and connectivity in two endemic Mediterranean corals: Astroides calycularis (Pallas, 1766) and Cladocora caespitosa (Linnaeus, 1767), of P. Casado-Amezúa (2012). http://hdl.handle.net/10261/134913This article documents the addition of 238 microsatellite marker loci and 72 pairs of Single Nucleotide Polymorphism (SNP) sequencing primers to the Molecular Ecology Resources Database. Loci were developed for the following species: Adelges tsugae, Artemisia tridentata, Astroides calycularis, Azorella selago, Botryllus schlosseri, Botrylloides violaceus, Cardiocrinum cordatum var. glehnii, Campylopterus curvipennis, Colocasia esculenta, Cynomys ludovicianus, Cynomys leucurus, Cynomys gunnisoni, Epinephelus coioides, Eunicella singularis, Gammarus pulex, Homoeosoma nebulella, Hyla squirella, Lateolabrax japonicus, Mastomys erythroleucus, Pararge aegeria, Pardosa sierra, Phoenicopterus ruber ruber and Silene latifolia. These loci were cross-tested on the following species: Adelges abietis, Adelges cooleyi, Adelges piceae, Pineus pini, Pineus strobi, Tubastrea micrantha, three other Tubastrea species, Botrylloides fuscus, Botrylloides simodensis, Campylopterus hemileucurus, Campylopterus rufus, Campylopterus largipennis, Campylopterus villaviscensio, Phaethornis longuemareus, Florisuga mellivora, Lampornis amethystinus, Amazilia cyanocephala, Archilochus colubris, Epinephelus lanceolatus, Epinephelus fuscoguttatus, Symbiodinium temperate-A clade, Gammarus fossarum, Gammarus roeselii, Dikerogammarus villosus and Limnomysis benedeni. This article also documents the addition of 72 sequencing primer pairs and 52 allele specific primers for Neophocaena phocaenoides.Peer reviewe