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

Pressure Dependence Of The Photooxidation Of Selected Carbonyl Compounds In Air: N-Butanal And N-Pentanal

Dilute mixtures of n-butanal and n-pentanal in synthetic air (up to 100 ppm) were photolyzed with fluorescent UV lamps (275--380 nm) in air at 298 K. The main photooxidation products, identified and quantitatively analyzed by FT-IR spectroscopy, were ethene (n-butanal) or propene (n-pentanal), CO, vinylalcohol and ethanal. The photolysis rates and the absolute quantum yields # of both compounds were found to be slightly dependent on the total pressure. At 100 Torr, in the photolysis of n-butanal and n-pentanal # 100 0.02 and 0.40 0.04, whereas at 700 Torr, the total quantum yields were # 700 0.38 0.02 and 0.32 0.01, respectively. These results could be explained by the collisional deactivation of photoexcited molecules. Two decomposition channels were identified in both cases: the radical channel RCHO R HCO, and the molecular channel C x H y CHO C x-1 H y-3 CH 2 =CHOH, having the relative yields of 68 3% (n-butanal), and 20 4% (n-pentanal) at 700 Torr. The product, CH 2 =CHOH, tautomerizes to ethanal. UV absorption cross-sections were measured prior to photolysis. For the comparison, the products were also analyzed after photolysis of both compounds in teflon bags using direct sunlight. 2001 Elsevier Science B.V. All rights reserved

Effect of phenol on germination capacity and polyphenol oxidase, peroxidase and catalase activities in lettuce

In this study we examined the activities of polyphenol oxidase (PPO) and antioxidant enzymes, peroxidase (POX) and catalase (CAT) during lettuce seed germination at different concentrations of phenol. Out of eleven varieties of lettuce, four were chosen according to their germination tolerance to phenol as follows: plants exhibiting high (Ljubljanska ledenka - LJL and Nansen - N) and low toleranace (Little Gem - LG and Majska kraljica - MK). A decrease in germination efficiency after exposure to LD50 of phenol was determined for these four varieties. The effects of phenol treatment on POX, CAT and PPO activities were determined after 4, 5, 6, 7 and 8 days of growth at LD50 concentrations. A trend of increased peroxidase activity was observed in seeds grown on LD50 of phenol compared to control seeds. A significant increase in CAT activity was observed at the beginning of treatment for MK, LG and N in seeds grown on phenol as well as in control seeds. A trend of increased PPO activity was observed in all control seeds. We also investigated the affinity of PPO for two different substrates that were used for the determination of enzyme activity. Our results show that LJL and N are the varieties most tolerant to growth on phenol. Here we report on the activities of their antioxidant enzymes and PPO during seed germination.Serbian Ministry of Education, Science and Technological Development {[}ON173017

Production of hairy root cultures of lettuce (Lactuca sativa L.)

Hairy root cultures of lettuce (Lactuca sativa L.) were obtained by inoculation of cotyledonary leaves of in vitro lettuce seedlings (cvs. Nansen and Ljubljanska ledenka) with Agrobacterium rhizogenes A4M70GUS. Approximately in 96.7\% cvs. Nansen and in 91.2\% Ljubljanska ledenka inoculated explants produced hairy root when they were incubated on Murashige and Skoog (MS) half-strength medium without plant growth regulators. A total of 54\% of all hairy root cultures expressed GUS activity. Every hairy root represented an independent transformation event. Line Ljubljanska ledenka 18 showed the highest biomass (5.5 times the biomass of control root). A PCR analysis of the genomic DNA confirmed the presence of marker and target genes in 15 hairy roots examined.Ministry of Education, Science and Technological Development of the Republic of Serbia {[}TR-31019

Drought impacts on photosynthesis, isoprene emission and atmospheric formaldehyde in a mid-latitude forest

Isoprene plays a critical role in air quality and climate. Photosynthesis (gross primary productivity, GPP) and formaldehyde (HCHO) are both related to isoprene emission at large spatiotemporal scales, but neither is a perfect proxy. We apply multiple satellite products and site-level measurements to examine the impact of water deficit on the three interlinked variables at the Missouri Ozarks site during a 20-day mild dryness stress in summer 2011 and a 3-month severe drought in summer 2012. Isoprene emission shows opposite responses to the short- and long-term droughts, while GPP was substantially reduced in both cases. In 2012, both remote-sensed solar-induced fluorescence (SIF) and satellite HCHO column qualitatively capture reductions in flux-derived GPP and isoprene emission, respectively, on weekly to monthly time scales, but with muted responses. For instance, as flux-derived GPP approaches zero in late summer 2012, SIF drops by 29–33% (July) and 19–27% (August) relative to year 2011. A possible explanation is that electron transport and photosystem activity are maintained to a certain extent under the drought stress. Similarly, flux tower isoprene emissions in July 2012 are 54% lower than July 2011, while the relative reductions in July for 3 independent satellite-derived HCHO data products are 27%, 12% and 6%, respectively. We attribute the muted HCHO response to a photochemical feedback whereby reduced isoprene emission increases the oxidation capacity available to generate HCHO from other volatile organic compound sources. Satellite SIF offers a potential alternative indirect method to monitor isoprene variability at large spatiotemporal scales from space, although further research is needed under different environmental conditions and regions. Our analysis indicates that fairly moderate reductions in satellite SIF and HCHO column may imply severe drought conditions at the surface