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

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

Data from: Abrupt shortening of bird W chromosomes in ancestral Neognathae

As a result of suppressed recombination, heterogametic sex chromosomes (either Y or W) are usually assumed to gradually shorten over evolutionary time as a way to remove accumulated mutations. However, suppressed recombination removes the most obvious mechanism for excising portions of sex chromosomes. We examined ratios of W/Z chromosome size across 224 bird species from 146 genera. Much of the data were obtained from a previous study (Rutkowska et al. 2012. Biology Letters 8: 636–638), who, similar to ourselves, found no gradual decrease in W chromosome length over evolutionary time. However, we show an abrupt decrease in W chromosome length at or just after the phylogenetic split between the two extant bird superorders, Paleognathae and Neognathae, indicating that the key to understanding sex chromosome evolution may have little to do with gradual suppression of recombination

A comparison of the larvivorous habits of exotic Poecilia reticulata and native Aplocheilus parvus

Abstract Background The exotic fish Poecilia reticulata is promoted in the tropics as a biological control agent for aquatic pathogenic carriers, such as mosquitoes. Such control measures are often adopted blindly, ignoring the potential of native species and the adverse effects of introduced species. The present study was conducted to assess the diet composition of two species of fish, the native Aplocheilus parvus and exotic P. reticulata, and to assess the availability of food items in their natural environment in four types of aquatic systems. Diet composition was estimated using 24 h gut contents analysis, in a clay quarry pit and a perennial reservoir for A. parvus, and in a man-made canal and a second-order natural stream for P. reticulata. Food items in these environments were quantified by analyzing water samples collected every 2 h. Results The diet of A. parvus in the clay quarry pit and reservoir consisted of adult or larval stages of Insecta, Maxillopoda and Malacostraca. In both habitats, A. parvus selectively fed on insect parts and insect larvae. The diet of P. reticulata consisted of filamentous algae, diatoms and detritus. The diet of A. parvus showed active selection of insectivore food items against their low availability. In contrast, the diet of P. reticulata showed consumption of food items in accordance with their availability in the environment. The highest mean number of food items in the gut for A. parvus was recorded around mid-day in the clay quarry pit, but no peak feeding time was identified in the perennial reservoir. For P. reticulata, peak feeding was recorded around mid-day in both the habitats. Conclusion Irrespective of the type of environment and rate of occurrence, A. parvus preferred insect and insect larvae, whereas P. reticulata consumed the most readily available food items. The active selection of insects by A. parvus suggests they may have value as a biological control agent

Maternal high-fat diet induces sex-specific changes to glucocorticoid and inflammatory signaling in response to corticosterone and lipopolysaccharide challenge in adult rat offspring

Abstract Background Maternal obesity as a result of high levels of saturated fat (HFD) consumption leads to significant negative health outcomes in both mother and exposed offspring. Offspring exposed to maternal HFD show sex-specific alterations in metabolic, behavioral, and endocrine function, as well as increased levels of basal neuroinflammation that persists into adulthood. There is evidence that psychosocial stress or exogenous administration of corticosterone (CORT) potentiate inflammatory gene expression; however, the response to acute CORT or immune challenge in adult offspring exposed to maternal HFD during perinatal life is unknown. We hypothesize that adult rat offspring exposed to maternal HFD would show enhanced pro-inflammatory gene expression in response to acute administration of CORT and lipopolysaccharide (LPS) compared to control animals, as a result of elevated basal pro-inflammatory gene expression. To test this, we examined the effects of acute CORT and/or LPS exposure on pro and anti-inflammatory neural gene expression in adult offspring (male and female) with perinatal exposure to a HFD or a control house-chow diet (CHD). Methods Rat dams consumed HFD or CHD for four weeks prior to mating, during gestation, and throughout lactation. All male and female offspring were weaned on to CHD. In adulthood, offspring were ‘challenged’ with administration of exogenous CORT and/or LPS, and quantitative PCR was used to measure transcript abundance of glucocorticoid receptors and downstream inflammatory markers in the amygdala, hippocampus, and prefrontal cortex. Results In response to CORT alone, male HFD offspring showed increased levels of anti-inflammatory transcripts, whereas in response to LPS alone, female HFD offspring showed increased levels of pro-inflammatory transcripts. In addition, male HFD offspring showed greater pro-inflammatory gene expression and female HFD offspring exhibited increased anti-inflammatory gene expression in response to simultaneous CORT and LPS administration. Conclusions These findings suggest that exposure to maternal HFD leads to sex-specific changes that may alter inflammatory responses in the brain, possibly as an adaptive response to basal neuroinflammation

Abrupt shortening of bird W chromosomes in ancestral Neognathae

As a result of suppressed recombination, heterogametic sex chromosomes (either Y or W) are usually assumed to gradually shorten over evolutionary time as a way to remove accumulated mutations. However, suppressed recombination removes the most obvious mechanism for excising portions of sex chromosomes. We examined ratios of W/Z chromosome size across 224 bird species from 146 genera. Much of the data were obtained from a previous study (Rutkowska et al. 2012. Biology Letters 8: 636-638), who, similar to ourselves, found no gradual decrease in W chromosome length over evolutionary time. However, we show an abrupt decrease in W chromosome length at or just after the phylogenetic split between the two extant bird superorders, Paleognathae and Neognathae, indicating that the key to understanding sex chromosome evolution may have little to do with gradual suppression of recombination

Removal of Phosphate from Aqueous Solutions Using Chemically Synthesized Vaterite Polymorph of Porous Calcium Carbonate Nanoparticles under Optimized Conditions

Eutrophication is one of the most adverse impacts of nutrient contamination of water bodies where the phosphate is considered to be the primary limiting factor. The vaterite polymorph of porous calcium carbonate nanoparticles (VPCCNPs) were synthesized and used to remove orthophosphate ions in water. In this study, the VPCCNPs were synthesized chemically, using calcium acetate and sodium bicarbonate in a water-ethylene glycol media, at a temperature of 100°C, in a reaction time of 24 hours. Synthesized nanoparticles were characterized by X-ray diffractometry to confirm that the crystalline phase of calcium carbonate formed is spherical vaterite polymorph. Scanning electron microscopy coupled with energy dispersive X-ray analysis further confirms the spherical shape of the vaterite nanoparticles and the presence of only calcium, carbon, and oxygen thus showing high purity of the synthesized calcium carbonate nanoparticles. The dynamic laser light scattering-based particle size analysis (DLS) shows the average particle size to be 25.5 nm. The Fourier transform infrared spectroscopy was used to find functional groups before and after the adsorption of phosphate by vaterite nanoparticles. The phosphate removal efficiency of synthesized nanoparticles was tested with different concentrations of phosphate solutions (2–80 mg/L), pH levels (5–12), adsorbent dosages (0.025–0.250 g), and contact times (5–120 min). Ion chromatography was used to analyse the phosphate concentrations in water samples. The maximum phosphate removal percentage of 100% was obtained with 50 mL of 2 mg/L phosphate solution and 0.15 g of the synthesized nanoparticle. Adsorption data were well fitted with the Langmuir adsorption isotherm model and the pseudo-second-order kinetic model with R2 of 0.99 and 0.98 (rate constant -0.083 g g-1 min-1), respectively. The presence of F−, NO3−, and SO42− has no effect on phosphate adsorption since 100% phosphate removal is obtained in the presence of these ions. Furthermore, the particle shows a 100% removal of orthophosphate ions available in eutrophic water regardless of the presence of many other ions in natural water bodies. The study presents a viable option for removing excess phosphate in natural water to desirable levels as a means for controlling eutrophication