The impact of green fnance on environmental degradation in BRI region

The Belt and Road Initiative (BRI) is one of the largest infrastructure projects in the world, accounting for more than 30% of global GDP and 60% of world population. The economic growth of BRI member countries can be improved signifcantly, attributable to the success‑fulness of the infrastructure projects. The increased economic growth indirectly leads to higher energy consumption and environmental damage. In response to this, the BRI estab‑ lished a new concept and version of the project, namely green BRI. Thus, this study aims to examine if green fnance plays a signifcant role in mitigating environmental degradation in the BRI region. Utilising a Generalised Method of Moments approach, we fnd green fnance is negatively and signifcantly correlated with environmental degradation, suggest‑ing green fnance play an essential role to reduce the deterioration of environmental qual‑ ity, while enhancing economic growth at the same time. In conclusion, BRI member states should continue promoting green fnance by implementing incentive schemes, such as subsidising interest rates for the green loan, reducing corporate tax and establishing green credit guarantee scheme. Besides, in order simultaneously enhance economic growth, pro‑mote sustainability and achieve the 2030 Sustainable Development Goals, both governments and private sector should work hand in hand to promote green transformation of BRI

ICAR: endoscopic skull‐base surgery

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Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

International Consensus Statement on Rhinology and Allergy: Rhinosinusitis

Background: The 5 years since the publication of the first International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR‐RS) has witnessed foundational progress in our understanding and treatment of rhinologic disease. These advances are reflected within the more than 40 new topics covered within the ICAR‐RS‐2021 as well as updates to the original 140 topics. This executive summary consolidates the evidence‐based findings of the document. Methods: ICAR‐RS presents over 180 topics in the forms of evidence‐based reviews with recommendations (EBRRs), evidence‐based reviews, and literature reviews. The highest grade structured recommendations of the EBRR sections are summarized in this executive summary. Results: ICAR‐RS‐2021 covers 22 topics regarding the medical management of RS, which are grade A/B and are presented in the executive summary. Additionally, 4 topics regarding the surgical management of RS are grade A/B and are presented in the executive summary. Finally, a comprehensive evidence‐based management algorithm is provided. Conclusion: This ICAR‐RS‐2021 executive summary provides a compilation of the evidence‐based recommendations for medical and surgical treatment of the most common forms of RS

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

Automated semiquantitative analysis of protein macroarrays

Protein arrays are systematically arranged, large collections of annotated proteins on planar surfaces commonly used for the characterisation of protein binding events against a wide range of possible probes. These may include analyses of protein-protein, peptide-protein, enzyme-substrate or antibody-antigen interactions from simple reagents to complex mixtures. Absence of appropriate image analysis and data processing software may bestow a substantial hurdle limiting the uptake of protein arrays in research. We developed a first, automated semiquantitative open source software package for the analysis of widely used protein macroarrays. The software allows accurate single array and inter-array comparative studies through the tackling of intra-array inconsistencies arising from experimental disparities. The innovative and automated image analysis process includes adaptive positioning, background identification and subtraction, removal of null signals, robust statistical analysis, and protein pair validation. The normalized values allow a convenient semiquantitative data analysis of different samples or timepoints, enabling accurate characterisation of sample series to identify relative changes for instance in clinical samples in response to diseases and treatment

Coalescence Processes of Droplets and Liquid Marbles

The coalescence process of droplets and, more recently, of liquid marbles, has become one of the most essential manipulation schemes in digital microfluidics. This process is indispensable for realising microfluidic functions such as mixing and reactions at microscale. This paper reviews previous studies on droplet coalescence, paying particular attention to the coalescence of liquid marbles. Four coalescence systems have been reviewed, namely, the coalescence of two droplets freely suspended in a fluid; the coalescence of two sessile droplets on a solid substrate; the coalescence of a falling droplet and a sessile droplet on a solid substrate; and liquid marble coalescence. The review is presented according to the dynamic behaviors, physical mechanisms and experimental parameters of the coalescence process. It also provides a systematic overview of how the coalescence process of droplets and liquid marbles could be induced and manipulated using external energy. In addition, the practical applications of liquid marble coalescence as a novel microreactor are highlighted. Finally, future perspectives on the investigation of the coalescence process of liquid marbles are proposed. This review aims to facilitate better understanding of the coalescence of droplets and of liquid marbles as well as to shed new insight on future studies

Picking up and placing a liquid marble using dielectrophoresis

A liquid marble is a droplet coated with hydrophobic powder. The porous and hydrophobic coating prevents physical contact between the liquid and its surroundings without compromising gas exchange. As such, the liquid marble is an excellent platform for culturing cells. With the promising biomedical applications of the liquid marble, numerous studies have been conducted to improve its handling using magnetism, which limits the liquid marble coating to hydrophobised ferromagnetic materials. In this paper, we propose a novel, simple and cheap method of liquid marble manipulation such as pick and place based on the well-known dielectrophoresis force. Liquid marbles of various volumes were picked up using an electrode with a high voltage bias, moved to a different location and placed intact. This method provides reliable handling to a host of existing non-ferromagnetic liquid marbles without the need to engineer their coatings. Furthermore, this method enables the automation of the liquid marble handling process. This paper provides an empirical relationship to link the pickup force to the experimental parameters