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

Fractional excretion of electrolytes during pre- and postpartum periods in cows

In this study, fractional excretions (Fe) of sodium (Na), potassium (K), chloride (Cl), calcium (Ca), magnesium (Mg) and phosphorus (PO4) were examined with the aim to demonstrate interactions between fractional excretions of these electrolytes within each period and relate them to electrolyte metabolism in clinically normal cows at different stages of lactation and dry period. The material of this study consisted of 20 clinically healthy Holstein-Friesian cows of the same age and milk yield. Blood and urine samples were collected on 190-200th, 240-250th and 270-280th days of pregnancy and on days 1-7th, 35-45th and 75-85th after calving, altogether 6 times. An increase was observed in FeCa and FeMg during the transition from the lactation to the dry period (p < 0.05), and a decrease in FeCa (p < 0.05), FeMg (p < 0.01) in the 2nd month of the dry period. FePO4 and FeMg, respectively, increased on levels of p < 0.01 and p < 0.05, while FeCa decreased on a level of p < 0.05 after gestation compared to the level before gestation. FeNa and FeK showed a decrease of p < 0.001 and p < 0.01, respectively, between the 1st and 2nd months of the dry period, while after gestation this value showed an increase in FeNa (p < 0.05) and FeK (p < 0.01). FeCl increased significantly (p < 0.05) only from postpartum to the 1st month of lactation. There was a strong positive correlation between FeNa and FeCl in all of the periods. It was concluded that there were significant changes in the Fe of Na, K, Cl, Ca, PO4 and Mg before parturition and during lactation; these changes could have an important role in assessing renal function and electrolyte balance

Feedback For A Simulation Practice On Communication Skills In Pharmacy Education: A Pilot Study

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Effects of hypotaurine, cysteamine and aminoacids solution on post-thaw microscopic and oxidative stress parameters of Angora goat semen

This study was conducted to determine the effects of cysteamine, hypotaurine and aminoacids solution (BME) on standard semen parameters, lipid peroxidation and antioxidant activities of Angora goat semen after the freeze-thawing process. Ejaculates collected from four Angora goats were evaluated and pooled at 37 degrees C. Semen samples, which were diluted with a Tris-based extender containing the antioxidants hypotaurine (5 mM) and cysteamine (5 mM), and an aminoacid solution (13%), and an extender containing no antioxidants (control), were cooled to 5 degrees C and frozen in 0.25-ml French straws in liquid nitrogen. Frozen straws were thawed individually at 37 degrees C for 20 s in a water bath for evaluation

Taxonomic classification and identification of fine leaved fescues collected from Eastern Anatolia of Turkey using flow cytometer

Fescues are a very complex group of grasses of the Poaceae family. They have a wide adaptation as they are distributed all over the world. The close morphological resemblance of species (Festuca spp.) makes their identification and classification difficult. Therefore, it is not clear how many true species are included in the genus Festuca, but the estimated range is beween 400 and 500 species. It is well-known that nuclear DNA content among species varies considerably, and it accompanies the evolution of species and species groups. This is mainly because of chromosomal variations, but similar differences also exist among closely related species with the same chromosome number. Also, natural hybridization due to open pollination presents difficulties in distinguishing closely related taxa using morphological analysis. The objective of this study was to determine nuclear DNA content and ploidy level of over 130 populations of fescues collected from the natural flora of Eastern Anatolia by flow cytometer using PI as Fluorochrome. Based on the results of nuclear DNA content analysis, 2C nuclear DNA content of populations varied between 4.63 and 15.03 pg. These results indicate that fescue genetic materials collected from nature have a mixture of different species and ploidy levels. Therefore, prior characterization is a necessity before including them in breeding programmes. The results also indicated that flow cytometry provides easy, fast, relatively economic and reliable method to screen newly collected populations of plant genetic resources. © 2020 International Society for Horticultural Science. All rights reserved.113O156, AR.13.01This study was supported by Namik Kemal University and TUBITAK with project numbers NKUBAP.00.24.AR.13.01 and 113O156, respectively