The Impacts of Unsustainable Urbanization on the Environment

Urban areas—cities—are not simply geographic areas for human gathering but are a locus of economic production, cultural and social interactions, and ecological development. Therefore, cities create positive development values when planned and managed on a sustainable footing by considering institutional, governance, environmental, political, economic, coherent policies, cultural, and social conditions and requirements. Sustainable urbanization has multiple benefits including creating more employment opportunities and better incomes, hubs for innovative solutions by attracting competencies, enhancing land utilization efficiency, improving infrastructural performance, providing better services (e.g., education, health, water supply, and electricity), economic growth hub, acting as knowledge centers, better social and cultural life, and providing better living standards. While the impacts of rapid unsustainable urbanization are water stress, scarcity, and high consumption, sanitation wastewater, water pollution, air pollution, climate change, noise pollution, cultivated land depleted, urban sprawl, dust, solid and hazardous wastes, destruction of biodiversity, high energy consumption, traffic congestion, soil pollution, and deforestation. Thus, the 2030 Agenda for Sustainable Development—and its sustainable development goals (SDGs)—and New Urban Agenda are key transformative power toward sustainable urbanization development; this development is not at the expense of the environment while leading to prosperity and improving quality of life

The Role of Industrial Sector in Pollution Control in the Context of Sustainable Development Goals

The sustainable development goals (SDGs) constitute an opportunity to engage the industrial sector to enhance its role in preserving the environment. The industrial sector has an essential role in economic growth, job creation, innovations, and sustainability. No matter the scale of the industry, it is small or large; thus, all companies can contribute to the SDGs toward a better future. Pollution problems are the root cause that hinders attain sustainable development in the industrial sectors. Thus, global challenges are climate change, water pollution and scarcity, air pollution, and resource depletion needs to be tackled collaboratively, and the industrial sector can contribute to the solution through pollution control and sustainable innovations. In the rapid transformations of business models and systems for the future and the fourth industrial revolution, the industrial sector has a crucial role; without it cannot save the environment and improve the economy and human health. To transform the current industrial systems toward a more feasible eco-friendly needs significant cooperation and coordination among concerned stakeholders. To do so, firstly, industries need to adjust their strategies and plans to be consistent and coherent to start the transformation process toward sustainable industrial development

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Towards Effective Environmental Sustainability Reporting in the Large Industrial Sector of Bahrain

The industrial sector plays a vital role in economic development; therefore, there is a necessity to integrate sustainability into industrial development to maintain the economy and avoid any degradation impacts on the environment, and thereafter on society. Thus, do Bahraini companies have sustainability reports and if so, are these reports based on GRI guidelines? Has the status of their sustainability reports been analyzed? This research aims to examine the sustainability reports of companies by analyzing the status of sustainability aspects in their materiality matrices to assist in identifying and prioritizing the most significant sustainability issues for advancement in their future reporting and to improve their environmental performance. This study employs a content analysis approach and analyzes 11 reports from the period 2016–2020 for three companies in Bahrain’s large industrial sector. The study reveals that the companies using materiality analysis in their reporting benefit from better monitoring and measuring of their environmental performance, and from implementing SDGs. Furthermore, the study indicates that the utilization of a materiality matrix as a reporting tool can define and improve report contents by considering stakeholders’ views, consequently, improving the quality of the sustainability reports. The study concludes by proposing a set of recommendations

The Role of Epithelial Cell Adhesion Molecule Cancer Stem Cell Marker in Evaluation of Hepatocellular Carcinoma

Background and Objectives: Hepatocellular carcinoma (HCC) is a prevalent form of malignancy that is characterized by high mortality rates and prognosis that remain suboptimal, largely due to treatment resistance mechanisms. Recent studies have implicated cancer stem cells (CSCs), particularly those expressing epithelial cell adhesion molecule (EpCAM), in HCC progression and resistance. In the present study, we sought to assess EpCAM expression in HCC patients and its correlation with various clinicopathological parameters. Materials and Methods: Tissue samples from 42 HCC patients were subjected to immunohistochemical staining to evaluate EpCAM expression. Clinicopathological data were obtained including the size, grade and stage of tumors, vascular invasion status, alpha-fetoprotein levels, and cirrhosis status. The Chi square and Fisher’s exact tests were employed to assess the association between categorical groups. Independent Student-t test or Mann–Whitney U test was used to investigate the association between continuous patient characteristics and survival. Results: Immunohistochemical analysis revealed EpCAM expression in 52.5% of HCC cases. EpCAM-positive tumors exhibited characteristics indicative of aggressive disease, including larger tumor sizes (p = 0.006), greater tumor multiplicity (p = 0.004), higher grades (p = 0.002), more advanced stages (p = 0.003), vascular invasion (p = 0.023), elevated alpha-fetoprotein levels (p = 0.013), and cirrhosis (p = 0.052). Survival analysis demonstrated that EpCAM expression was significantly associated with lower overall rates of survival and higher rates of recurrence in HCC patients. Conclusions: Our findings suggest that EpCAM expression may serve as a prognostic biomarker for HCC with a potential role in patient management. Targeting EpCAM-positive CSCs may represent a promising approach to overcome treatment resistance and improve clinical outcomes in HCC. However, further investigation into the molecular mechanisms underlying EpCAM’s role in HCC progression is warranted to facilitate the development of personalized therapeutic interventions

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods: The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results: NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion: As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population