The existential risk space of climate change

Interventions to Reduce Surgical Waste Burden: A Systematic Review

Background

Operating suites are significant drivers of waste, pollution, and costs. Surgeons can help fight the climate crisis by implementing innovative strategies aimed at mitigating the environmental impact of surgical procedures and decreasing operational costs, and moving toward a more sustainable healthcare system. This study aims to review the literature describing interventions that reduce surgical waste.

Methods

PubMed, Cochrane, and Embase were searched. Studies reporting interventions to reduce operative waste, including emissions, energy, trash, and other, were included. Case reports, opinion-based reports, reviews, and meta-analyses were excluded. Study quality was rated using MINORS and Jadad scales. Data were extracted from each study to calculate waste on a per case basis. Narrative review of studies was performed rather than meta-analysis.

Results

The search yielded 675 unique hits, of which 13 (level of evidence: I-III) met inclusion criteria. Included studies were categorized by intervention type in relation to the operating and procedure room. Three studies evaluated provider education initiatives, three evaluated setup of instruments, two evaluated single-use items, four evaluated technique changes, and one evaluated surgical venue. Seven studies reported significant reductions in disposable surgical waste throughput, and seven reported significant reductions in cost.

Conclusions

The results of this systemic review demonstrated the effectiveness of surgical waste reduction initiatives in reducing waste volume, cost, and carbon emissions. Within plastic surgery, minimal surgical packs resulted in reduced gross waste and cost while promoting patient satisfaction in hand surgery, supporting the continued development and implementation of such initiatives in a surgical context.

Potential impacts of proposed lithium extraction on biodiversity and conservation in the contiguous United States

To address climate change, the United States is offering consumers incentives to purchase electric vehicles containing domestically derived lithium batteries. New extraction facilities required to supply this lithium may have environmental impacts, including impacts on biodiversity. To reveal potential impacts, we mapped 72 proposed lithium extraction sites across the contiguous United States and overlaid these with data for species occurrences, conservation value, habitat, and land management designations. We found that potential impacts vary by site. The abundance of lithium resources in the United States, combined with large differences in potential impacts among sites, suggests that decision-makers may be able to guide lithium extraction to the least impactful sites first. To aid this process, we recommend field-based reconnaissance of proposed lithium extraction sites, and a cumulative analysis of potential impacts on biodiversity in order to contextualize this activity within the larger scope of land use and climate change.

Climate change, society, and pandemic disease in Roman Italy between 200 BCE and 600 CE

Records of past societies confronted with natural climate change can illuminate social responses to environmental stress and environment-disease connections, especially when locally constrained high-temporal resolution paleoclimate reconstructions are available. We present a temperature and precipitation reconstruction for ~200 BCE to ~600 CE, from a southern Italian marine sedimentary archive-the first high-resolution (~3 years) climate record from the heartland of the Roman Empire, stretching from the so-called Roman Climate Optimum to the Late Antique Little Ice Age. We document phases of instability and cooling from ~100 CE onward but more notably after ~130 CE. Pronounced cold phases between ~160 to 180 CE, ~245 to 275 CE, and after ~530 CE associate with pandemic disease, suggesting that climate stress interacted with social and biological variables. The importance of environment-disease dynamics in past civilizations underscores the need to incorporate health in risk assessments of climate change.

Demonstration of SARS-CoV-2 Exposure in Korean Native Cattle and Korean Native Black Goats in Korea

The COVID-19 pandemic is caused by the zoonotic SARS-CoV-2 virus. A wide range of animals that interact with humans have been investigated to identify potential infections. As the extent of infection became more apparent, extensive animal monitoring became necessary to assess their susceptibility. This study analyzed nasal swabs and blood samples collected from randomly selected Korean native cattle and Korean native black goats. The tests conducted included real-time qPCR to detect SARS-CoV-2 antigens, an ELISA to detect antibodies, and a plaque reduction neutralization test (PRNT) to determine the presence of neutralizing antibodies. Among the 1798 animals tested (consisting of 1174 Korean native cattle and 624 Korean native black goats), SARS-CoV-2 viral RNA was detected in one Korean native cattle and one Korean native black goat. ELISA testing revealed positive results for antibodies in 54 Korean native cattle (4.60%) and 16 Korean native black goats (2.56%), while PRNTs yielded positive results in 51 Korean native cattle (4.34%) and 14 Korean native black goats (2.24%). The presence of SARS-CoV-2 antigens and/or antibodies was identified in animals on farms where farmworkers were already infected. It is challenging to completely rule out the possibility of reverse zoonotic transmission from humans to livestock in Korea, although the transmission is not to the same extent as it is in highly susceptible animal species like minks, cats, and dogs. This is due to the limited geographical area and the dense, intensive farming practices implemented in these regions. In conclusion, continuous viral circulation between humans and animals is inevitable, necessitating ongoing animal monitoring to ensure public health and safety.

Placing diverse knowledge systems at the core of transformative climate research

We argue that solutions-based research must avoid treating climate change as a merely technical problem, recognizing instead that it is symptomatic of the history of European and North American colonialism. It must therefore be addressed by decolonizing the research process and transforming relations between scientific expertise and the knowledge systems of Indigenous Peoples and of local communities. Partnership across diverse knowledge systems can be a path to transformative change only if those systems are respected in their entirety, as indivisible cultural wholes of knowledge, practices, values, and worldviews. This argument grounds our specific recommendations for governance at the local, national, and international scales. As concrete mechanisms to guide collaboration across knowledge systems, we propose a set of instruments based on the principles of consent, intellectual and cultural autonomy, and justice. We recommend these instruments as tools to ensure that collaborations across knowledge systems embody just partnerships in support of a decolonial transformation of relations between human communities and between humanity and the more-than-human world.

Evidence of Exposure to SARS-CoV-2 in Dogs and Cats from Households and Animal Shelters in Korea

The COVID-19 pandemic was caused by the zoonotic SARS-CoV-2. A variety of animals involved in human life worldwide have been investigated for infection. As the degree of infection increased, extensive monitoring in animals became necessary to determine the degree of infection in animals. The study was conducted on a sample of dogs and cats, which were randomly sampled according to the number of confirmed cases in the region. Animals from both COVID-19-confirmed households and generally disease-negative families and animal shelters were included. Tests included real-time qPCR tests for SARS-CoV-2 antigens, ELISA for antibodies, and plaque reduction neutralization tests (PRNT) for neutralizing antibodies. As a result, SARS-CoV-2 viral RNA was detected in 2 cats out of 1018 pets (672 dogs and 346 cats). A total of 16 dogs (2.38%) and 18 cats (5.20%) tested positive using ELISA, and 14 dogs (2.08%) and 17 cats (4.91%) tested positive using PRNT. Antigens of- and/or antibodies to SARS-CoV-2 were detected in the animals regardless of whether the companion family was infected; this was the case even in animal shelters, which have been regarded as relatively safe from transmission. In conclusion, continuous viral circulation between humans and animals is inevitable; therefore, continuous monitoring in animals is required.