27 research outputs found

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

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    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

    ActP controls copper homeostasis in Rhizobium leguminosarum bv. viciae and Sinorhizobium meliloti preventing low pH-induced copper toxicity

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    Two 'calcium-irreparable' acid-sensitive mutants were identified after mutagenizing Rhizobium leguminosarum bv. viciae and Sinorhizobium meliloti with Tn5. Each mutant contains a single copy of the transposon which, inserted within the actP gene, prevents expression of a P-type ATPase that belongs to the CPx heavy metal-transporting subfamily. Here, we show that both actP-knockout mutants show sensitivity to copper; omission of this heavy metal from low pH-buffered media restores acid tolerance to these strains. Furthermore, complementation of the mutant phenotype requires only the actP gene. An actP-gusA fusion in R. leguminosarum was transcriptionally regulated by copper in a pH-dependent manner. Downstream to actP in both organisms is the hmrR gene that encodes a heavy metal-responsive regulator (HmrR) that belongs to the merR class of regulatory genes. Insertional inactivation of hmrR abolished transcriptional activation of actP by copper ions and increased the basal level of its expression in their absence. These observations suggest that HmrR can regulate actP transcription positively and negatively. We show that copper homeostasis is an essential mechanism for the acid tolerance of these root nodule bacteria since it prevents this heavy metal from becoming overtly toxic in acidic conditions

    A gene region conferring stress tolerance to Rhizobium leguminosarum bv viciae and Sinorhizobium meliloti

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    Keywords: Acid Tolerance Rhizobium Leguminosarum Root Nodule Bacterium Rhizobial Mutant Insertional Inactivatio

    A continental perspective on the timing of environmental change during the last glacial stage in Australia

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    The timing and duration of the coldest period in the last glacial stage, often referred to as the last glacial maximum (LGM), has been observed to vary spatially and temporally. In Australia, this period is characterised by colder, and in some places more arid, climates than today. We applied Monte-Carlo change point analysis to all available continuous proxy records covering this period, primarily pollen records, from across Australia (n = 37) to assess this change. We find a significant change point occurred (within uncertainty) at 28.6 ± 2.8 ka in 25 records. We interpret this change as a shift to cooler climates, associated with a widespread decline in biological productivity. An additional change point occurred at 17.7 ± 2.2 ka in 24 records. We interpret this change as a shift towards warmer climates, associated with increased biological productivity. We broadly characterise the period between 28.6 (± 2.8) - 17.7 (± 2.2) ka as an extended period of maximum cooling, with low productivity vegetation that may have occurred as a combined response to reduced temperatures, lower moisture availability and atmospheric CO2. These results have implications for how the spatial and temporal coherence of climate change, in this case during the LGM, can be best interrogated and interpreted
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