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

On the dynamics of interface between formal and informal economies in LDCs

SIGLEAvailable from British Library Document Supply Centre- DSC:3597.3243(IDS-DP--301) / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Egypte : années 80 : éléments pour un bilan de l'"ouverture"

Bilan et réflexion sur l'expérience de planification urbaine au Caire au cours des 30 dernières années à travers l'étude des schémas directeurs de 1953, 1970 et 1981, tels sont les deux thèmes abordés par l'article. Pour chacun des 3 schémas directeurs sont analysés le contexte politique, économique et social de leur élaboration, les procédures d'élaboration, les options prises et les modalités de mise en oeuvre qui reflètent la nature de l'Etat et des alliances de classe

Neoproterozoic Deformation in the Northeastern Part of the Saharan Metacraton, Northern Sudan

The northeastern part of the Saharan Metacraton is dominated by medium to high-grade gneisses and migmatites, disrupted by belts of low-grade volcano-sedimentary sequences representing arc assemblages and highly dismembered ophiolites, and intruded by A-type granitoids. This part of the Saharan Metacraton is affected by three Neoproterozoic deformation events: (1) Emplacement of S- to SE-verging nappes of ophiolites and passive margin sediments. The most prominent of these nappes is the Atmur-Delgo fold and thrust belt which extends westward from the eastern margin of the Saharan Metacraton to just east of the Third Cataract Nile. This belt is interpreted as manifesting the closure of a restricted oceanic basin between the Bayuda and Halfa Terranes at ~700-650 Ma. (2) Development of N- to NE-trending folds as a result of E-W shortening that accompanied NW-SE oblique collision between the Saharan Metacraton and the Arabian-Nubian Shield at ~650-590 Ma. This event, although dominantly localized along the Keraf Suture at the boundary between the Saharan Metacraton and the Arabian-Nubian Shield, also resulted in deformation within the northeastern part of the Saharan Metacraton. N- to NE-trending folds occur either as broad belts (Wadi Halfa Fold Belt) or narrow and discrete zones (Third Cataract Shear Zone). Thrust stacking and folding thickened the Saharan Metacraton lithosphere as shown by numerous gneissic domes, such as the Delgo Dome, in the northern part of the Bayuda Terrane. Crustal thickening also generated A-type granitoids that intrude the northeastern part of the Saharan Metacraton. E-W shortening culminated in the development of ~590-550 Ma, N- to NNW-trending sinistral strike-slip shear zones, sometimes coinciding with the N-trending fold belts as in the case of the Third Cataract Shear Zone. (3) Thickening of the Saharan Metacraton lithosphere triggered orogenic collapse with N-trending moderate-angle normal-slip faults developed after 550 Ma. Neoproterozoic deformation and igneous activity in the northeastern part of the Saharan Metacraton are interpreted as due to processes that involve collision, lithospheric mantle delamination, and regional extension

Information quantifiers for trapped ion in a carrier excitation laser field

The laser field interacting with single trapped ion in a carrier excitation frame in the presence of an external field is investigated. Detailed analytical expressions are given, taking into account carrier excitation configurations. We study the evolution of the population inversion, fidelity, ion-field entanglement, Fisher information and the geometric phase. The results indicate the influence of the external field on the information quantities to describe some physical phenomena. The relation between the population inversion, fidelity, von Neumann entropy, Fisher information, and geometric phase are explored during the time evolution

Effects of Bleomycin, Selenium, and Vitamin E on Male Fertility: A Review

Bleomycin (BL) is a glycopeptide antibiotic derived from the bacterium Streptomyces verticillus that is commonly used in the treatment of human cancer. However, BL has been linked to several cases of male infertility in humans and animals. Vitamin E requires vascular transport to the liver after absorption, which is primarily facilitated by tocopheroltransfer protein. Vitamin E acts as a peroxyl radical scavenger as an antioxidant, preventing free radical propagation in tissues by reacting with them to form a tocopheryl radical, which is reduced by a hydrogen donor and returns to its reduced state. Because of its solubility, it is incorporated into cell membranes, protecting them from oxidative damage. Vitamin E plays critical roles in improving reproductive efficiency and mitigating the negative effects of several reproductive toxicants. Selenium is a trace element found in soil, water, and certain foods. It is thought to be an essential component that actively participates in a variety of metabolic pathways and plays a variety of important roles in the body. Among these functions are participation in various enzyme systems and anti-oxidative cellular processes. Selenium is required for the detoxification of harmful metals from the human body, foetal breathing, energy transfer reactions, and sperm cell formation. It is thought that a lack of selenium contributes to male infertility because it causes degradation in the testicular tissues, which leads to impaired active sperm motility as the first sign of impending infertility. In this review, we will summarize the recent findings related to BL-adverse effects of male fertility and the beneficial effects of selenium and vitamin E on the reproduction and male fertility