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

Obtención de ingredientes bioactivos mediante tecnologías verdes

En los últimos años ha incrementado el interés en el desarrollo de procesos medioambientalmente limpios para la obtención de extractos y compuestos con actividad funcional (y alto valor añadido) a partir de fuentes naturales. Las ventajas de estos nuevos procesos son: su carácter ?verde? (GRAS, Generally Recognized As Safe), que permite garantizar la ausencia de contaminación en los productos e ingredientes obtenidos, y su eficacia, inocuidad y selectividad, que favorecen su implementación industrial. El objetivo del trabajo fue la obtención y caracterización química y funcional de ingredientes alimentarios con propiedades bioactivas a partir de semillas y vainas de caupí Colorado (Vigna unguiculata) del Nordeste Argentino. El método de extracción utilizado fue líquidos presurizados (PLE). Se realizó un diseño experimental por superficie de respuesta donde los factores fueron el número de ciclos de extracción (1-3), la temperatura (50-170 °C) y la composición del disolvente (medido como el porcentaje de etanol-agua (0-100%)). El resto de las condiciones de extracción se mantuvieron constantes considerando la experiencia previa del grupo. Las variables respuestas del diseño fueron el contenido total de polifenoles (TPC), el rendimiento de extracción (Y%), el valor TEAC (nmol trolox/g extracto) y el IC50 (µg/mL) (actividad antioxidante por radicales DPPH y ABTS). Para determinar las condiciones de extracción más adecuadas teniendo en cuenta los mejores valores posibles (mayor Y%, mayor TPC y TEAC e IC50 lo más baja posible), se realizó una optimización de respuesta múltiple considerando un peso estadístico similar para las cuatro variables de respuesta. Se determinó la composición química por cromatografía HPLC-MS/MS de los extractos de semillas y vainas obtenidos en las condiciones óptimas de extracción. La temperatura fue el factor más influyente en el rendimiento de extracción en semillas y vainas. Además, a partir de las superficies de respuesta es posible observar grandes similitudes para el contenido total de fenoles y las dos respuestas de actividad antioxidante en semillas y vainas. Para estas variables respuestas, en ambas muestras, la temperatura fue el factor más influyente, observando un aumento significativo de 50 a 170 °C para la misma mezcla de solvente (50 % etanol) y una disminución a la temperatura intermedia (110 °C). En las cuatro superficies de respuesta se observó un efecto positivo de la mezcla etanol-agua (50 %) en semillas y vainas. Las condiciones óptimas de extracción implicaron el uso de 50% de etanol en agua como mezcla de solventes, 170 °C y 1 ciclo de extracción para semillas y 3 ciclos de extracción para vainas. Los resultados experimentales obtenidos en las condiciones óptimas coincidieron con los predichos, lo que confirma la validez de nuestro modelo. Se lograron identificar alrededor de 20 polifenoles, de los cuales en semillas predominaron las proanticianidinas y flavonoles mientras que en vainas hubo mayor proporción de ácidos fenólicos. El PLE ha demostrado ser un proceso ecológico, y útil para la extracción de polifenoles de semillas y vainas de caupi, lo cual valoriza a este cultivo regional ya que estaría brindando compuestos bioactivos con gran potencial como ingrediente en la formulación de alimentos.Fil: Avanza, María Victoria. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste. Instituto de Química Básica y Aplicada del Nordeste Argentino. Universidad Nacional del Nordeste. Facultad de Ciencias Exactas Naturales y Agrimensura. Instituto de Química Básica y Aplicada del Nordeste Argentino; Argentina. Universidad Nacional del Nordeste. Facultad de Ciencias Exactas Naturales y Agrimensura. Laboratorio de Tecnología Química; ArgentinaFil: Alvarez Rivera, Gerardo. Consejo Superior de Investigaciones Científicas. Instituto de Investigación en Ciencias de la Alimentación; EspañaFil: Mendiola, Jose. Consejo Superior de Investigaciones Científicas. Instituto de Investigación en Ciencias de la Alimentación; EspañaFil: Ibañez,Elena. Consejo Superior de Investigaciones Científicas. Instituto de Investigación en Ciencias de la Alimentación; EspañaXXI Congreso Latinoamericano y del Caribe de Ciencia y Tecnología de Alimentos y XVII Congreso Argentino de Ciencia y Tecnología de AlimentosBuenos AiresArgentinaAsociación Argentina de Tecnólogos Alimentario

In Vitro Study of the Blood–Brain Barrier Transport of Natural Compounds Recovered from Agrifood By-Products and Microalgae

Agrifood by-products and microalgae represent a low-cost and valuable source of bioactive compounds with neuroprotective properties. However, the neuroprotective effectiveness of therapeutic molecules can be limited by their capacity to cross the blood–brain barrier (BBB) and reach the brain. In this research, various green extracts from Robinia pseudoacacia (ASFE), Cyphomandra betacea (T33), Coffea arabica (PPC1), Olea europaea L., (OL-SS), Citrus sinensis (PLE100) by-products and from the microalgae Dunaliella salina (DS) that have demonstrated in vitro neuroprotective potential were submitted to an in vitro BBB permeability and transport assay based on an immortalized human brain microvascular endothelial cells (HBMEC) model. Toxicity and BBB integrity tests were performed, and the transport of target bioactive molecules across the BBB were evaluated after 2 and 4 h of incubation using gas and liquid chromatography coupled to quadrupole-time-of-flight mass spectrometry (GC/LC-Q-TOF-MS). The HBMEC-BBB transport assay revealed a high permeability of representative neuroprotective compounds, such as mono- and sesquiterpenoids, phytosterols and some phenolic compounds. The obtained results from the proposed in vitro BBB cellular model provide further evidence of the neuroprotective potential of the target natural extracts, which represent a promising source of functional ingredients to be transferred into food supplements, food additives, or nutraceuticals with scientifically supported neuroprotective claims

Stability Studies of Starch Aerogel Formulations for Biomedical Applications

Starch aerogels are attractive materials for biomedical applications because of their low density and high open porosity coupled with high surface areas. However, the lack of macropores in conventionally manufactured polysaccharide aerogels is a limitation to their use as scaffolds for regenerative medicine. Moreover, the stability under storage of polysaccharide aerogels is critical for biomedical purposes and scarcely studied so far. In this work, the induction of a new macropore population (1–2 μm) well integrated into the starch aerogel backbone was successfully achieved by the incorporation of zein as a porogen. The obtained dual-porous aerogels were evaluated in terms of composition as well as morphological, textural, and mechanical properties. Stability of aerogels upon storage mimicking the zone II (25 °C, 65% relative humidity) according to the International Council for Harmonization guideline of climatic conditions was checked after 1 and 3 months from morphological, physicochemical, and mechanical perspectives. Zein incorporation induced remarkable changes in the mechanical performance of the end aerogel products and showed a preventive effect on the morphological changes during the storage period

An Alternative Exploitation of <i>Synechocystis</i> sp. PCC6803: A Cascade Approach for the Recovery of High Added-Value Products

Microalgal biomass represents a very interesting biological feedstock to be converted into several high-value products in a biorefinery approach. In this study, the cyanobacterium Synechocystis sp. PCC6803 was used to obtain different classes of molecules: proteins, carotenoids and lipids by using a cascade approach. In particular, the protein extract showed a selective cytotoxicity towards cancer cells, whereas carotenoids were found to be active as antioxidants both in vitro and on a cell-based model. Finally, for the first time, lipids were recovered from Synechocystis biomass as the last class of molecules and were successfully used as an alternative substrate for the production of polyhydroxyalkanoate (PHA) by the native PHA producer Pseudomonas resinovorans. Taken together, our results lead to a significant increase in the valorization of Synechocystis sp. PCC6803 biomass, thus allowing a possible offsetting of the process costs

Alternative Use of Extracts of Chipilín Leaves (Crotalaria longirostrata Hook. &amp; Arn) as Antimicrobial

The genus Crotalaria comprises about 600 species that are distributed throughout the tropics and subtropical regions of the world; they are antagonistic to nematodes in sustainable crop production systems, and have also shown antimicrobial capacity. Chipilín (C. longirostrata), which belongs to this genus, is a wild plant that grows in the state of Chiapas (Mexico) and is traditionally is used as food. Its leaves also have medicinal properties and are used as hypnotics and narcotics; however, the plant has received little research attention to date. In the experimental part of this study, dried leaves were macerated by ethanol. The extract obtained was fractionated with ethyl ether, dichloromethane, ethyl acetate, 2-propanone, and water. The extracts were evaluated against three bacteria—namely, Escherichia coli (Ec), Citrobacter freundii (Cf), and Staphylococcus epidermidis (Se)—and three fungi—Fusarium oxysporum A. comiteca (FoC), Fusarium oxysporum A. tequilana (FoT), and Fusarium solani A. comiteca (FSC). During this preliminary study, a statistical analysis of the data showed that there is a significant difference between the control ciprofloxacin (antibacterial), the antifungal activity experiments (water was used as a negative control), and the fractions used. The aqueous fraction (WF) was the most active against FoC, FsC, and FoT (30.65, 20.61, and 27.36% at 96 h, respectively) and the ethyl ether fraction (EEF) was the most active against Se (26.62% at 48 h)