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

The influence of social network on couples’ intention to have the first child

Background: Recently, the relevance of social interactions as determinants of behavioral intentions has been increasingly perceived, but there is a lack of knowledge on how and why it interacts with couples’ fertility intentions. Objective: This qualitative study was conducted to explore the influence of social network on couples’ intention to have their first child in urban society of Mashhad, Iran in 2011. Materials and Methods: In this exploratory qualitative study in-depth interviews were conducted with 24 participants including 14 fertile women, two parents, three husbands and five midwives and health care providers. The sample was selected purposively in urban health centers, homes and workplaces until data saturation was achieved. Data analysis was carried out adopting conventional content analysis approach through giving analytical codes and identification of categories using MAXqda software. Study rigor verified via prolonged engagement, validation of codes through member check and peer debriefing. Results: Findings from data analysis demonstrated four major categories about social network’s influence on couples’ intention to have their first child including 1) perception of fertility relevant social network, 2) occurrence of various types of social influence 3) subjective judgment to the benefits of social network and its fitness to personal life, and 4) couples’ interaction with social network. Conclusion: Managing the fertility behaviors need to include the consideration of personal social networks surrounding the couples. It is important to apply the study findings in providing family planning services and dissemination of appropriate fertility behaviors through community-based reproductive health care delivery system

The influence of social network on couples' intention to have the first child

Background: Recently, the relevance of social interactions as determinants of behavioral intentions has been increasingly perceived, but there is a lack of knowledge on how and why it interacts with couples� fertility intentions. Objective: This qualitative study was conducted to explore the influence of social network on couples� intention to have their first child in urban society of Mashhad, Iran in 2011. Materials and Methods: In this exploratory qualitative study in-depth interviews were conducted with 24 participants including 14 fertile women, two parents, three husbands and five midwives and health care providers. The sample was selected purposively in urban health centers, homes and workplaces until data saturation was achieved. Data analysis was carried out adopting conventional content analysis approach through giving analytical codes and identification of categories using MAXqda software. Study rigor verified via prolonged engagement, validation of codes through member check and peer debriefing. Results: Findings from data analysis demonstrated four major categories about social network�s influence on couples� intention to have their first child including 1) perception of fertility relevant social network, 2) occurrence of various types of social influence 3) subjective judgment to the benefits of social network and its fitness to personal life, and 4) couples� interaction with social network. Conclusion: Managing the fertility behaviors need to include the consideration of personal social networks surrounding the couples. It is important to apply the study findings in providing family planning services and dissemination of appropriate fertility behaviors through community-based reproductive health care delivery system. Key Words: Fertility, Childbirth, Social network, Qualitative study, Content analysi

Analysis of selective potato varieties and their functional assessment

Abstract The number of attributes, related to the selection of potato varieties, was evaluated with reference to their potential in chip processing. Five commercial varieties of potato were analyzed regarding their physico-chemical, functional, and processing aspects. In general, Lady Rosetta subsequently, Chipsona were the most noticeable potato varieties considering their physical attributes. A significant correlation (R = 0.925) was estimated amongst geometric mean diameter and surface area. Maximum dry matter and starch contents were observed in Lady Rosetta followed by Chipsona. Desiree showed higher fat, sugar and mineral contents than all other selected potato cultivars. Promising correlation (R= 0.952) was estimated among total minerals and ash contents. Functional traits were recorded maximum in Desiree followed by Lady Rosetta. A significant correlation (R = 0.907) was described between total phenolic contents and radical scavenging activity. Lady Rosetta proved to be the most preferred potato variety considering post processing parameters followed by Chipsona

Soil organic carbon stock variation with climate and land use in shale derived soils

Anthropogenic activities, urbanization and industrialization cause an increase in the atmospheric carbon dioxide. Current focus of the soil scientists and the environmentalists is to quantify the carbon stocks and its flow in the agroecological system which is one of the main causes of global warming and climate change. The information on the distribution of soil organic carbon (SOC) stocks in the soil profiles in relation with changing climate is barely sufficient. Objective of this study was to quantify the effect of climate and land on the equilibrium of SOC stocks in soil profiles with development. Murree soil series (Typic Hapludolls) in humid climate and under coniferous forest, and Tirnul soil series (Typic Haplustepts) in semiarid climate under cultivation, were selected. Triplicate soil profiles were selected for each of the soils and sampled at genetic horizons level. Cumulative SOC stocks in Typic Hapludolls soil profiles (95 Mg ha-1) were significantly greater than Typic Haplustepts (30 Mg ha-1). The Typic Hapludolls had significantly greater SOC stock at each horizon level under humid climate. This research concludes that soils under forest and humid climate had higher SOC stocks as compared to the soils under semiarid climate and cultivation

Beyond prediction: unveiling the prognostic power of μ-opioid and cannabinoid receptors, alongside immune mediators, in assessing the severity of SARS-CoV-2 infection

Abstract Background This study aims to explore the potential of utilizing the expression levels of cannabinoid receptor 2 (CB2), μ-opioid receptor (MOR), MCP-1, IL-17, IFN-γ, and osteopontin as predictors for the severity of SARS-CoV-2 infection. The overarching goal is to delineate the pathogenic mechanisms associated with SARS-CoV-2. Methods Using quantitative Real-time PCR, we analyzed the gene expression levels of CB2 and MOR in nasopharynx specimens obtained from patients diagnosed with SARS-CoV-2 infection, with 46 individuals classified as having severe symptoms and 46 as non-severe. Additionally, we measured the circulating levels of MCP-1, IL-17, IFN-γ, and osteopontin using an ELISA assay. We examined the predictive capabilities of these variables and explored their correlations across all patient groups. Results Our results demonstrated a significant increase in MOR gene expression in the epithelium of patients with severe infection. The expression of CB2 receptor was also elevated in both male and female patients with severe symptoms. Furthermore, we observed concurrent rises in MCP-1, IL-17, IFN-γ, and osteopontin levels in patients, which were linked to disease severity. CB2, MOR, MCP-1, IL-17, IFN-γ, and osteopontin showed strong predictive abilities in distinguishing between patients with varying degrees of SARS-CoV-2 severity. Moreover, we identified a significant correlation between CB2 expression and the levels of MOR, MCP-1, osteopontin, and IFN-γ. Conclusions These results underline the interconnected nature of molecular mediators in a sequential manner, suggesting that their overexpression may play a role in the development of SARS-CoV-2 infections. Graphical Abstrac