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

Chemical and techno-functional properties of flours from peeled and unpeeled oleaster (Elaeagnus angustifolia L.)

Oleaster flours were produced from two different genotypes (GO1 and GO2) and methods (peeled oleaster flour: POF and unpeeled oleaster flour: UPOF). Oleaster flour samples (OFs) contained high levels of dietary fibers and micro minerals. The contents of Fe, Cu, B, and Cr in flours obtained from oleaster fruits were higher in UPOF than in POF samples. Palmitic acid was the major fatty acid which was followed by oleic acid and lignoceric acid. All samples contained greater amount of saturated fatty acids (SFA) as compared to mono unsaturated fatty acids (MUFA) and polyunsaturated fatty acids (PUFA). Among seven different organic acids detected, the level of citric acid was the highest and it was followed by malic, acetic and oxalic acids. High nutritional contents of oleaster flour indicated that it is a good source of dietary fiber, micro minerals, as well as organic and fatty acids. The water solubilities (WS) and water absorption capacities (WAC) of oleaster flours were adequate for their utilization. They also seem to have an improving effect on emulsion properties of albumin. These results highlighted that it is possible to use the oleaster flour in some processed foods such as bakery goods, dairy products (ice cream and yoghurt), beverages and confectionery. Moreover, the oleaster flour could also be used in the preparation of low-fat, high-fiber dietetic products due to its high dietary fiber content. © 2015 The Author(s)

Consumer Price Index 2001, August

Suomen virallinen tilasto (SVT

Clinical and prognostic features of plasmacytomas: A multicenter study of Turkish Oncology Group-Sarcoma Working Party

PubMed ID: 18543343To identify the outcomes of prognostic factors of solitary plasmacytoma mainly treated with local radiotherapy (RT). The data were collected from 80 patients with solitary plasmacytoma (SP). Forty patients (50.0%) received radiotherapy (RT) alone while 38 of them (47.5%) were treated with surgery (S) and RT. The median radiation dose was 46 Gy (range 30-64). The median follow up was 2.41 years (range 0.33-12.33). Ten-year overall survival (OS) and local relapse-free survival (LRFS) were 73% and 94%, respectively. The median progression-free survival (PFS) and multiple myeloma-free survival (MMFS) were 3.5 years and 4.8 years, respectively. On multivariate analyses, the favorable factors were radiotherapy dose of >50 Gy and RT + S for PFS and younger age for MMFS. For the patients with medullary plasmacytoma, the favorable factor was younger age for MMFS. RT at ?50 Gy and RT + S may be favorable prognostic factors on PFS. Younger patients, especially with head-neck lesion and without pre-RT macroscopic tumor, seem to have the best outcome when treated with RT ± S. Progression to MM remains as the main problem especially for older patients. © 2008 Wiley-Liss, Inc

Mathematical analysis of maximum power generated by photovoltaic systems and fitting curves for standard test conditions Modelo matemático da potência máxima gerada por sistemas fotovoltaicos e curvas de ajuste às condições de teste em campo

The rural electrification is characterized by geographical dispersion of the population, low consumption, high investment by consumers and high cost. Moreover, solar radiation constitutes an inexhaustible source of energy and in its conversion into electricity photovoltaic panels are used. In this study, equations were adjusted to field conditions presented by the manufacturer for current and power of small photovoltaic systems. The mathematical analysis was performed on the photovoltaic rural system I-100 from ISOFOTON, with power 300 Wp, located at the Experimental Farm Lageado of FCA/UNESP. For the development of such equations, the circuitry of photovoltaic cells has been studied to apply iterative numerical methods for the determination of electrical parameters and possible errors in the appropriate equations in the literature to reality. Therefore, a simulation of a photovoltaic panel was proposed through mathematical equations that were adjusted according to the data of local radiation. The results have presented equations that provide real answers to the user and may assist in the design of these systems, once calculated that the maximum power limit ensures a supply of energy generated. This real sizing helps establishing the possible applications of solar energy to the rural producer and informing the real possibilities of generating electricity from the sun.<br>A eletrificação rural é caracterizada pela dispersão geográfica da população, baixo consumo, alto investimento por consumidor e elevado custo operacional. Por outro lado, a radiação solar constitui-se numa inesgotável fonte energética, e para sua conversão em energia elétrica são utilizados painéis fotovoltaicos. Neste trabalho, foram determinadas equações ajustadas às condições de campo apresentadas pelo fabricante para corrente e potência de sistemas fotovoltaicos de pequeno porte. A análise matemática foi feita sobre o sistema fotovoltaico rural I-100 da ISOFOTON, com potência de 300 Wp, localizado na Fazenda Experimental Lageado da FCA/UNESP. Para o desenvolvimento de tais equações, procurou-se estudar o circuito elétrico de células fotovoltaicas, aplicar os métodos numéricos iterativos para a determinação de parâmetros elétricos e analisar possíveis erros na adequação das equações existentes da literatura à realidade. Sendo assim, foi proposta a simulação de um painel fotovoltaico por meio de equações matemáticas que foram ajustadas segundo os dados de radiação locais. Os resultados apresentam equações que fornecem respostas reais para o usuário e podem auxiliar no dimensionamento destes sistemas, uma vez que a potência máxima calculada garante um limite de fornecimento da energia gerada. Este real dimensionamento auxilia a determinação das possíveis aplicações da energia solar para o produtor rural, informando as possibilidades reais de geração de energia elétrica pelo Sol