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

How an unusual chemosensory system forms arrays on the bacterial nucleoid

International audienc

The lrp gene and its role in type I fimbriation in Citrobacter rodentium

I studied the lrp gene of the murine pathogen C. rodentium and found that it encodes a product highly similar to members of the Lrp (leucine-responsive regulatory protein) family of transcriptional regulators, able to recognize leucine as an effector and to repress the expression of its own structural gene. In enterobacteria, Lrp is a global regulator of gene expression, as it controls a large variety of genes, including those coding for cell appendages and other potential virulence factors. Based on the well-established role of Lrp on the expression of pilus genes in Escherichia coli, I also studied the role of Lrp in controlling the formation of the type I pilus in C. rodentium. Type I pili, produced by the fim system, are virulence factors of uropathogens, involved in mediating bacterial adhesion to bladder epithelial cells. Yeast agglutination assays showed that Lrp is needed for type I pilus formation and real-time PCR experiments indicated that Lrp has a strong leucine-mediated effect on the expression of the fimAICDFGH operon. Mutant studies indicated that this positive action is exerted mainly through a positive control of Lrp on the phase variation mechanism that regulates fimAICDFGH expression. A quantitative analysis of its expression suggested that this operon may also be negatively regulated at the level of transcription. Finally, in vitro experiments showed that the C. rodentium type I pilus is involed in the internalization of this bacteria in uroepithelial cells, opening the possibility to use C. rodentium as an in vivo model system of human significant pathogens, as uropathogenic strains of E. coli

The rise of lignin biorefinery

Lignocellulosic biomass, ranging from softwood to agriculture and forestry wastes, represents the most abundant resource for modern biorefinery. In the course of the last years, we have witnessed the rise of \u2018reductive catalytic fractionation\u2019 processes of lignocellulosics in which priority attention is given to lignin that is \u2018first\u2019 converted into aromatic feedstocks. This opinion outlines recent advances in the reductive valorization of lignocellulosic biomass via lignin-first biorefinery approach, with particular emphasis on the fundamental catalytic reactions involved in the extraction and depolymerization of lignin and in the stabilization of the obtained phenolic units. Finally, a brief overview on the further transformations of lignin-derived monolignols and phenolics into value-added chemicals, fuels, polymeric materials, and active pharmaceutical ingredients is presented

Upgrading Lignocellulosic Biomasses: Hydrogenolysis of Platform Derived Molecules Promoted by Heterogeneous Pd-Fe Catalysts

This review provides an overview of heterogeneous bimetallic Pd-Fe catalysts in the C–C and C–O cleavage of platform molecules such as C2–C6 polyols, furfural, phenol derivatives and aromatic ethers that are all easily obtainable from renewable cellulose, hemicellulose and lignin (the major components of lignocellulosic biomasses). The interaction between palladium and iron affords bimetallic Pd-Fe sites (ensemble or alloy) that were found to be very active in several sustainable reactions including hydrogenolysis, catalytic transfer hydrogenolysis (CTH) and aqueous phase reforming (APR) that will be highlighted. This contribution concentrates also on the different synthetic strategies (incipient wetness impregnation, deposition-precipitaion, co-precipitaion) adopted for the preparation of heterogeneous Pd-Fe systems as well as on the main characterization techniques used (XRD, TEM, H2-TPR, XPS and EXAFS) in order to elucidate the key factors that influence the unique catalytic performances observed

A Short Overview on the Hydrogen Production Via Aqueous Phase Reforming (APR) of Cellulose, C6-C5 Sugars and Polyols

The use of lignocellulosic biomasses for the production of renewable hydrogen is surely among the hot-topic research tasks. In this review, we report on the recent advances in the catalytic conversion of cellulose and its derived C6-C5 sugars (glucose, fructose, and xylose) and polyols (sorbitol and xylitol) into hydrogen via aqueous phase reforming (APR) reactions. The APR processes are considered to be new sustainable catalytic routes for converting the carbohydrate fraction of biomasses into hydrogen at milder reaction conditions if compared with the traditional reforming reactions. Particular emphasis is given to the development of new and active catalysts and to the optimization of reaction conditions that aimed to maximize hydrogen production with a low concentration of CO avoiding, at the same time, the formation of alkanes

Cellular Targeting and Segregation of Bacterial Chemosensory Systems

International audienc

A New Biorefinery Approach for the Full Valorisation of Anchovy Residues: Use of the Sludge Generated during the Extraction of Fish Oil as a Nitrogen Supplement in Anaerobic Digestion

Several anchovies species are captured all over the world; they are consumed fresh but also preserved by the industry, either by brine-fermentation or canning in oil. The industrial process generates large amounts of residue (about 50% of the original fish biomass) that is generally used to produce fish flour. In this paper, the advancement of a recently proposed process for the full valorisation of anchovies aimed at the extraction of fish oil (to be used as an omega-3 source) and at the production of biomethane through anaerobic digestion is presented. Particularly, in the experiments presented, a co-digestion of anchovy sludge—used as a nitrogen supplement—and market waste (5% and 95% on a Total Solids basis) was performed. Since the proposed extraction process uses, as a green-solvent, d-limonene, the well-known problems of toxicity for the anaerobic biomass must be overcome during the digestion process. As discussed below, the granular activated carbon (GAC) is used to reclaim and improve anaerobic digestion processes in a reactor displaying clear signs of inhibition. In fact, GAC demonstrates multiple benefits for anaerobic digestion, such as adsorption of toxic substances, biomass selection, and triggering of direct interspecies electron transfer (DIET)

Sustainable Exploitation of Coffee Silverskin in Water Remediation

Coffee silverskin (CS), the main solid waste produced from the coffee industry, has efficiently been used as adsorbent material to remove potential toxic metals (PTMs). In order to assess its suitability in water remediation, kinetic adsorption experiments of Cu2+, Zn2+, and Ni2+ ions from wastewater were carried out and the adsorption performance of the waste material was compared with that of another well-known waste from coffee industry, spent coffee grounds (SCG). By using CS as sorbent material, ion removal follows the order Cu2+ > Zn2+ > Ni2+ with the adsorption equilibrium occurring after about 20 min. The adsorption efficiency of Ni2+ ions is the same for both investigated materials, while Cu2+ and Zn2+ ions are removed to a lesser extent by using CS. Equilibrium-adsorption data were analyzed using two different isotherm models (Langmuir and Freundlich), demonstrating that monolayer-type adsorption occurs on both CS and SCG surfaces. The overall results support the use of coffee silverskin as a new inexpensive adsorbent material for PTMs from wastewater