Ecophysiological and anatomical changes due to uptake and accumulation of heavy metal in Brachiaria decumbens

The growth and developmental characteristics of grasses and their high biodiversity make such plants suitable for remediation of areas contaminated by heavy metals. Nevertheless, heavy metal toxic effect on the plants may cause alteration in their metabolic pathways, such as photosynthesis, respiration, and growth, modifying plant anatomy. This work aimed to evaluate the effect of levels of soil contamination (0, 7.5 % and 15 % m³ m-3) on biomass production, on photosynthetic characteristics and on anatomical changes in roots and leaves of brachiaria (Brachiaria decumbens Stapf.). After seeds were planted, seedlings were uprooted and replanted in vases containing soil at different contamination levels, being left to rest for 120 days. At the end of that time, plants presented reduced yield of root and shoot dry matter, contents of chlorophyll a, chlorophyll b, total chlorophyll and potential photosynthesis with increased of soil contamination. The cell layers of endodermis and exodermis in the root tissues and the cell walls of the xylem and cortical parenchyma all thickened as contamination increased. In the leaf tissues, the adaxial and abaxial epidermis presented increased thickness while the leaf blade presented reduced thickness as contamination increased with consequent change in the root growth rate. In general, the effects of heavy metal increased with the metal concentration. Some results indicate that B. decumbens seems to have some degree of heavy metal tolerance

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background: Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods: The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results: A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion: Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)