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

Efeito da disponibilidade de hospedeiro e de alimento nas características biológicas de Trichogramma galloi Zucchi (Hymenoptera, Trichogrammatidae)

Características biológicas de Trichogramma galloi Zucchi, 1988 foram avaliadas em laboratório onde esses parasitóides foram criados com ovos de Diatraea saccharalis (Lepidoptera, Pyralidae), com ou sem mel, e expostos a ovos do hospedeiro após 0, 6, 12, 24, 36, 48, 60, 72 e 84 horas da emergência. As taxas de parasitismo e de viabilidade mostraram-se elevadas para indivíduos que receberam alimento. A razão sexual não foi influenciada pelo alimento. O número de indivíduos por ovo somente mostrou diferença para aqueles adultos que não receberam alimento e permaneceram 6 horas sem ovos do hospedeiro. Conferindo o efeito da disponibilidade de ovos, somente a razão sexual, com ou sem mel, não mostrou diferenças. Os resultados mostram que T. galloi necessita de um suprimento de carboidratos e que o tempo pode influenciar a capacidade reprodutiva

Capacidade de dispersão de Trichogramma em tomateiro estaqueado Dispersion capacity of Trichogramma pretiosum in propped up tomato

Estudou-se a capacidade de dispersão de Trichogramma pretiosum Riley em ovos de Anagasta kuehniella (Zeller), na cultura do tomateiro, em diferentes estágios fenológicos e sistemas de condução das plantas. A dispersão de T. pretiosum, 24 horas após a liberação, foi de 7,37 a 7,94 m. A área de dispersão foi de 120,20 a 138,72 m². O parasitismo foi de 53,1% a 87,3%, e significativo de acordo com o estágio fenológico da cultura. A liberação dos parasitóides para o controle de Tuta absoluta (Meyrick) deve ser feita em 75 pontos por hectare.<br>The dispersion capacity of Trichogramma pretiosum Riley was studied on Anagasta kuehniella (Zeller) eggs, in tomato field in different phenological stages and systems of conduction of the plants. The dispersion of T. pretiosum, 24 hours after the liberation, attained 7.37 to 7.94 m. The dispersion area was 120.20 to 138.72 m². Parasitism varies from 53.1% to 87.3% and it is significant according to the phenological stage of the crop. The parasitoids liberation for the control of Tuta absoluta (Meyrick) should be done in 75 points per hectare

Ocorrência de Trichogramma pretiosum em áreas comerciais de tomate, no Espírito Santo, em regiões de diferentes altitudes Occurrence of Trichogramma pretiosum in commercial fields of tomato, in Espírito Santo State (Brazil), in areas with different altitudes

Foram instalados sete campos experimentais em altitudes entre 200 e 1050 metros, nos municípios de Afonso Cláudio e Venda Nova do Imigrante no Espírito Santo, para desenvolvimento de avaliações pré-introdutórias de Trichogramma. Visou-se determinar as espécies nativas e conhecer o índice de parasitismo natural, para utilização em programas de manejo integrado da traça-do-tomateiro. Em todos os campos comerciais de tomateiros foram coletados apenas Trichogramma pretiosum Riley. No primeiro ano de coleta, o número médio de amostras de cartelas com parasitismo, bem como o número médio de ovos parasitados, apresentaram uma relação inversa, quando comparado com as regiões de altitudes entre 200 e 850 metros. Em regiões de menor altitude (200, 380 e 450 metros), foram observadas presença constante desses parasitóides de ovos em todas as áreas amostradas. No segundo ano de coleta não foi observado o mesmo comportamento em relação ao primeiro, tendo os valores médios dos parâmetros sido inferiores, com o número médio de ovos parasitados por cartela reduzido pela metade. Os resultados de dois anos de coleta mostraram que a agressividade das linhagens de T. pretiosum foi diferenciada em função das áreas.<br>Seven experimental fields were installed in altitudes varying from 200 to 1050 meters, located in Afonso Cláudio and Venda Nova do Imigrante in Espírito Santo State, Brazil. The evaluations of Trichogramma presence were done to determine the native species, know the natural parasitism rate in order to use the obtained results in programs of pest management of Tuta absoluta. In all commercial tomato fields only Trichogramma pretiosum Riley was collected. In the first year the medium number of egg-cards sample with parasitism, as well as the medium number of parasitized eggs, presented an inverse relationship when compared to the areas of altitude between 200 and 850 meters. In the lower areas (200, 380 and 450 m) a constant presence of parasitoid eggs in all the inspected areas was observed. In the second year the behavior differed from that of the first year. The medium values of the inferior parameters, with the medium number of eggs parasitized by cards, were reduced by half. The two year results showed that the aggressiveness of the T. pretiosum strains was differentiated depending on the area

Modelagem da recomendação de corretivos e fertilizantes para a cultura da soja Modeling lime and fertilizer recommendations for soybean

A recomendação de adubação para as culturas agrícolas, no Brasil, é feita com base em tabelas que relacionam a classe de disponibilidade do nutriente no solo com a dose a ser aplicada. Este trabalho apresenta uma alternativa para recomendar corretivos e fertilizantes para a cultura da soja, o SIRSo (sistema de recomendação de corretivos e fertilizantes para a cultura da soja). O princípio desse sistema é o balanço nutricional, ou seja, a recomendação se faz a partir da diferença entre o requerimento de nutrientes pela planta e o suprimento de nutrientes pelo solo, por resíduos orgânicos, por fertilizantes e pela calagem. O sistema considera ainda o fator sustentabilidade, visando manter uma quantidade de nutriente no solo capaz de garantir produtividade mínima em cultivos subseqüentes. Para recomendar calagem, o sistema considera dois métodos: a neutralização do Al3+ e a elevação dos teores de Ca2+ + Mg2+, ou a saturação por bases. O requerimento de nutrientes varia com a produtividade esperada de grãos, com as características do solo e com a taxa de recuperação pela planta do nutriente aplicado ao solo. O suprimento pelo solo depende da disponibilidade do nutriente, estimada a partir da análise de solo e da taxa de recuperação pelo extrator do nutriente aplicado. As comparações entre as recomendações geradas pelo SIRSo e aquelas oriundas das tabelas em uso no País mostram, em geral, que o SIRSo recomenda maior quantidade de nutrientes, principalmente de P e K quando consideradas as maiores produtividades, fato confirmado pela análise de sensibilidade, que mostrou grande variação da dose a ser recomendada desses nutrientes com a produtividade de grãos. Esse fato pode ser considerado como vantagem do SIRSo em relação às tabelas, muitas das quais apresentam pouca ou nenhuma variabilidade das doses em relação à produtividade.<br>Fertilizer recommendations for agricultural crops in Brazil are based on tables that relate indexes of nutrient availability in the soil with the required dose of the nutrient. This study presents an alternative for lime and fertilizer recommendations for soybean, called SIRSo. This lime and fertilizer recommendation system for soybean considers the nutritional balance, i.e., recommendations are based on the difference between plant nutrient requirement and the nutrient supply from the soil through organic residues, fertilizers and liming. The system further takes a sustainability factor into consideration, aiming at the maintenance of soil nutrient levels that ensure a desired minimum yield in subsequent cultivations. The system considers two methods for liming recommendations: Al3+ neutralization and increased Ca2+ + Mg2+ contents or base saturation. Nutrient requirements vary according to the expected grain yield, the soil characteristics and plant recovery rate of the nutrient applied to the soil. The soil supply depends on the estimated nutrient availability based on the soil analysis, and on the recovery rate of the applied nutrient by the extractor. Comparisons of SIRSo-based recommendations with those of the tables used nationwide show that SIRSo generally recommends higher nutrient quantities, mainly for P and K, when the highest yields are considered. This fact was confirmed by the sensitivity analysis, which detected wide variation of the recommended dose for these nutrients according to the grain yield. This fact is considered an advantage of SIRSo over the tables, where recommendations of doses according to the yield are little or not adjustable at all

Cerebrospinal fluid biomarkers in trials for Alzheimer and Parkinson diseases

Alzheimer disease (AD) and Parkinson disease (PD) are the most common neurodegenerative disorders. For both diseases, early intervention is thought to be essential to the success of disease-modifying treatments. Cerebrospinal fluid (CSF) can reflect some of the pathophysiological changes that occur in the brain, and the number of CSF biomarkers under investigation in neurodegenerative conditions has grown rapidly in the past 20 years. In AD, CSF biomarkers are increasingly being used in clinical practice, and have been incorporated into the majority of clinical trials to demonstrate target engagement, to enrich or stratify patient groups, and to find evidence of disease modification. In PD, CSF biomarkers have not yet reached the clinic, but are being studied in patients with parkinsonism, and are being used in clinical trials either to monitor progression or to demonstrate target engagement and downstream effects of drugs. CSF biomarkers might also serve as surrogate markers of clinical benefit after a specific therapeutic intervention, although additional data are required. It is anticipated that CSF biomarkers will have an important role in trials aimed at disease modification in the near future. In this Review, we provide an overview of CSF biomarkers in AD and PD, and discuss their role in clinical trials

AMAZONIA CAMTRAP: A data set of mammal, bird, and reptile species recorded with camera traps in the Amazon forest

The Amazon forest has the highest biodiversity on Earth. However, information on Amazonian vertebrate diversity is still deficient and scattered across the published, peer-reviewed, and gray literature and in unpublished raw data. Camera traps are an effective non-invasive method of surveying vertebrates, applicable to different scales of time and space. In this study, we organized and standardized camera trap records from different Amazon regions to compile the most extensive data set of inventories of mammal, bird, and reptile species ever assembled for the area. The complete data set comprises 154,123 records of 317 species (185 birds, 119 mammals, and 13 reptiles) gathered from surveys from the Amazonian portion of eight countries (Brazil, Bolivia, Colombia, Ecuador, French Guiana, Peru, Suriname, and Venezuela). The most frequently recorded species per taxa were: mammals: Cuniculus paca (11,907 records); birds: Pauxi tuberosa (3713 records); and reptiles: Tupinambis teguixin (716 records). The information detailed in this data paper opens up opportunities for new ecological studies at different spatial and temporal scales, allowing for a more accurate evaluation of the effects of habitat loss, fragmentation, climate change, and other human-mediated defaunation processes in one of the most important and threatened tropical environments in the world. The data set is not copyright restricted; please cite this data paper when using its data in publications and we also request that researchers and educators inform us of how they are using these data