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

Surface and Solubilisation Activities of 1-Amino-2-alkyloxynaphthalene-4-sodium Sulphonates

A series of 1-amino-2-alkyloxynaphthalene-4-sodium sulphonates was prepared by using octyl bromide, dodecyl bromide and cetyl bromide, respectively, with the sodium salt of 1-amino-2-naphthol-4-sulphonic acid in sodium ethoxide solution. The surface tensions, interfacial tensions and emulsifying efficiencies of the surfactants thus synthesised were studied in relation to the length of their hydrophobic chains. The critical micelle concentration (CMC), effectiveness (π CMC ), maximum surface excess (Γ max ) and minimum surface area (A min ) of the synthesised surfactants were also investigated. The effect of the chain lengths of these surfactants on the solubilisation rate (δS/δt) of paraffin oil in their micellar solutions was determined. The results revealed that different factors relating to surfactant structure have a considerable influence on solubilisation, particularly the hydrophilic/lipophilic balance (hlb) and the minimum area occupied by a molecule

The effect of pulpotomy base material on bacterial penetration and proliferation for pulpotomized primary molar teeth: A confocal laser scanning microscopy study

Introduction: the study aimed to evaluate Enterococcus Faecalis colonization in the pulp chamber in pulpotomized extracted human teeth filled by different pulpotomy base materials (PBMs), using confocal laser scanning microscopy (CLSM). Study design: Cavity preparations were made in 70 extracted primary molars. The pulp chambers were filled using either Intermediate restorative material (IRM), Mineral Trioxide Aggregate (MTA) or Glass ionomer (GI). Twenty-five teeth served controls. The specimens were sterilized, and coronally filled with bacterial suspension for 21 days. The specimens were cut through the furcation area, stained using LIVE/DEAD BacLight Bacterial Viability Kit and evaluated using CLSM. Results: The extent of fluorescent staining was larger in the GI group, compared to the IRM and MTA groups, and larger in the IRM group compared to the MTA group (P<0.05). The minimal and maximal bacterial penetration depths into the dentinal tubules were 55 and 695μm, respectively (mean 310μm), without differences between the materials (GI, IRM, MTA, p>0.05). The ratio of live bacteria to dead bacteria within the evaluated areas was higher in the GI group compared to the IRM and the MTA groups, and higher in the IRM group compared to the MTA group (P<0.05). There were no differences between the mesial, distal and apical parts in any of the evaluations (p>0.05). Conclusions: bacteria colonize the interface between the PBM and dentin and penetrate deeply into the dentinal tubules. The extent and the vitality of the colonized bacteria may be affected by the type of PBM

Multi-band analyses of the bright GRB~230812B and the associated SN2023pel

International audienceGRB~230812B is a bright and relatively nearby ($z =0.36$) long gamma-ray burst that has generated significant interest in the community and therefore has been subsequently observed over the entire electromagnetic spectrum. We report over 80 observations in X-ray, ultraviolet, optical, infrared, and sub-millimeter bands from the GRANDMA (Global Rapid Advanced Network for Multi-messenger Addicts) network of observatories and from observational partners. Adding complementary data from the literature, we then derive essential physical parameters associated with the ejecta and external properties (i.e. the geometry and environment) and compare with other analyses of this event (e.g. Srinivasaragavan et al. 2023). We spectroscopically confirm the presence of an associated supernova, SN2023pel, and we derive a photospheric expansion velocity of v $\sim$ 17$\times10^3$ km $s^{-1}$. We analyze the photometric data first using empirical fits of the flux and then with full Bayesian Inference. We again strongly establish the presence of a supernova in the data, with an absolute peak r-band magnitude $M_r = - 19.41 \pm 0.10$. We find a flux-stretching factor or relative brightness $k_{\rm SN}=1.04 \pm 0.09$ and a time-stretching factor $s_{\rm SN}=0.68 \pm 0.05$, both compared to SN1998bw. Therefore, GRB 230812B appears to have a clear long GRB-supernova association, as expected in the standard collapsar model. However, as sometimes found in the afterglow modelling of such long GRBs, our best fit model favours a very low density environment ($\log_{10}({n_{\rm ISM}/{\rm cm}^{-3}}) = -2.16^{+1.21}_{-1.30}$). We also find small values for the jet's core angle $\theta_{\rm core}={1.70^{+1.00}_{-0.71}} \ \rm{deg}$ and viewing angle. GRB 230812B/SN2023pel is one of the best characterized afterglows with a distinctive supernova bump