50 research outputs found
Male aggression varies with consortship rate and habitat in a dolphin social network
- Author
- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- 01/10/2019
- Field of study
Coalitions and alliances exemplify the core elements of conflict and cooperation in animal societies. Ecological influences on alliance formation are more readily attributed to within-species variation where phylogenetic signals are muted. Remarkably, male Indo-Pacific bottlenose dolphins in Shark Bay, Western Australia, exhibit systematic spatial variation in alliance behavior, not simply within a species or population, but within a single social network. Moving SE-NW along Peron Peninsula in Shark Bay, males ally more often in trios than pairs, consort females more often, and exhibit greater seasonal movements. Ecological models predict more male-male conflict in the north, but sufficient observations of aggression are lacking. However, dolphins often incur marks, in the form of tooth rakes, during conflicts. Here we report that the incidence of new tooth rake marks varies systematically in the predicted pattern, with greater marking in the north, where males form more trios and consort females at a higher rate. While our previous work demonstrated that alliance complexity has an ecological component, we can now infer that ecological variation impacts the level of alliance-related conflict in Shark Bay
Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease
- Author
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- Yamaguchi E
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- Yao Z
- Yaoqing H
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- Yasutake M
- Yigit Z
- Yilmaz Mb
- Yim Kh
- Yim S
- Yokoyama M
- Yong H
- Yoshida M
- Yoshimoto E
- Yossen M
- Young A
- Younis L
- Youssef G
- Yuan Z
- Yunoki C
- Yupanqui H
- Z Zhai
- Z Zilahi
- Zadionchenko V
- Zadra R
- Zagozen P
- Zaidman C
- Zalazar L
- Zaman A
- Zangroniz P
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- Zareczky P
- Zarifis I
- Zdrenghea D
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- Zena N
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- Zhou H
- Zidova M
- Zielinski M
- Zieve F
- Zineldine A.
- Zirlik A
- Zucchetti C
- Publication venue
- 'Massachusetts Medical Society'
- Publication date
- 01/01/2017
- Field of study
Background: Experimental and clinical data suggest that reducing inflammation without affecting lipid levels may reduce the risk of cardiovascular disease. Yet, the inflammatory hypothesis of atherothrombosis has remained unproved. Methods: We conducted a randomized, double-blind trial of canakinumab, a therapeutic monoclonal antibody targeting interleukin-1β, involving 10,061 patients with previous myocardial infarction and a high-sensitivity C-reactive protein level of 2 mg or more per liter. The trial compared three doses of canakinumab (50 mg, 150 mg, and 300 mg, administered subcutaneously every 3 months) with placebo. The primary efficacy end point was nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death. RESULTS: At 48 months, the median reduction from baseline in the high-sensitivity C-reactive protein level was 26 percentage points greater in the group that received the 50-mg dose of canakinumab, 37 percentage points greater in the 150-mg group, and 41 percentage points greater in the 300-mg group than in the placebo group. Canakinumab did not reduce lipid levels from baseline. At a median follow-up of 3.7 years, the incidence rate for the primary end point was 4.50 events per 100 person-years in the placebo group, 4.11 events per 100 person-years in the 50-mg group, 3.86 events per 100 person-years in the 150-mg group, and 3.90 events per 100 person-years in the 300-mg group. The hazard ratios as compared with placebo were as follows: in the 50-mg group, 0.93 (95% confidence interval [CI], 0.80 to 1.07; P = 0.30); in the 150-mg group, 0.85 (95% CI, 0.74 to 0.98; P = 0.021); and in the 300-mg group, 0.86 (95% CI, 0.75 to 0.99; P = 0.031). The 150-mg dose, but not the other doses, met the prespecified multiplicity-adjusted threshold for statistical significance for the primary end point and the secondary end point that additionally included hospitalization for unstable angina that led to urgent revascularization (hazard ratio vs. placebo, 0.83; 95% CI, 0.73 to 0.95; P = 0.005). Canakinumab was associated with a higher incidence of fatal infection than was placebo. There was no significant difference in all-cause mortality (hazard ratio for all canakinumab doses vs. placebo, 0.94; 95% CI, 0.83 to 1.06; P = 0.31). Conclusions: Antiinflammatory therapy targeting the interleukin-1β innate immunity pathway with canakinumab at a dose of 150 mg every 3 months led to a significantly lower rate of recurrent cardiovascular events than placebo, independent of lipid-level lowering. (Funded by Novartis; CANTOS ClinicalTrials.gov number, NCT01327846.
Soluble programmed cell death receptor-1 (sPD-1): a potential biomarker with anti-inflammatory properties in human and experimental acute respiratory distress syndrome (ARDS)
- Author
- A Ayala
- AB Millar
- Alfred Ayala
- B Wan
- C Blank
- C Guignant
- C Nielsen
- Chun-Shiang Chung
- Daithi S. Heffernan
- GR Bernard
- H Dong
- H Kuipers
- H Wu
- J Lomas-Neira
- Joanne Lomas-Neira
- K Tsushima
- L Armstrong
- L He
- L Xiao
- LB Ware
- LM Francisco
- M Denegri
- M Kasim
- M Perl
- ME Keir
- ND Ferguson
- P Brahmamdam
- P Sakthivel
- Q Pan
- R Busa
- RD Aubert
- RK Dinesh
- RK Thakkar
- Sean F. Monaghan
- SF Monaghan
- TM Hyers
- William G. Cioffi
- William G. Fairbrother
- X Huang
- X Wang
- Yaping Chen
- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- Field of study
Infected pancreatic necrosis: outcomes and clinical predictors of mortality. A post hoc analysis of the MANCTRA-1 international study
- Author
- Ababneh Hazim
- Abbas Kinan
- Abdalah Haidar M.
- Abdelsalam Wafaa
- Abdullaev Abakar
- Abid Izza
- Abradelo Manuel
- Acheimastos Vasileios
- Afzal Ameer
- Agarwal Rajendra
- Agnoletti Vanni
- Agresta Ferdinando
- Ahmed Salma
- Aiolfi Alberto
- Akalin Murat
- Akbar Ali
- Akin Emrah
- Aktimur Yunus Emre
- Al-Raimi Ibrahim
- Al-Shami Khayry
- Alawadhi Kamel
- Alconchel Felipe
- Alexandridou Eirini
- Ali Iyad
- Ali Syed Muhammad
- Aljaiuossi Osama
- Alla-Angelina Volovich
- Alshaikh Abdulrahman
- Alshargabi Haneen
- Altinel Yuksel
- Altintoprak Fatih
- Alvarez Fernando Andrés
- Ammendola Michele
- Anania Gabriele
- Andreotti Dario
- Andreuccetti Jacopo
- Anestiadou Elissavet
- Ani Mohd Firdaus Che
- Ansaloni Luca
- Anwaar Muhammad Hassan
- Aonzo Paolo
- Aparicio Antonio Carlos Maya
- Apollos Jeyakumar
- Argenio Giulio
- Arina Tsurbanova
- Armellino Mariano Fortunato
- Assenza Marco
- Atanasov Boyko
- Atici Semra Demirli
- Ausania Fabio
- Awad Ahmed
- Awadi Sajeda
- Azamat Ibrahim Fethi
- Álvarez-Torrado Andrea
- Badran Ali
- Bagaglini Giulia
- Baili Efstratia
- Bains Lovenish
- Balla Andrea
- Barone Mirko
- Bayhan Hüseyin
- Bayo Jose Muros
- Beasley Daniel
- Belev Nikolay
- Bellato Vittoria
- Belloni Elena
- Benuzzi Laura
- Bergamini Carlo
- Beristain-Hernandez Jose-Luis
- Bianchi Valentina
- Bianchini Matteo
- Biffl Walter
- Biloslavo Alan
- Bilyak Andriy
- Bini Roberto
- Bogoni Selene
- Bombardini Cristina
- Bona Davide
- Bond-smith Giles
- Bono Dario
- Bottari Andrea
- Bozkurt Mehmet Abdussamet
- Bracale Umberto
- Brachet Contul Riccardo
- Brachini Gioia
- Bradley Alison
- Butturini Giovanni
- Buwaitel Mohammad Musallam Khalil
- Cabrera Vicente Herrera
- Cabrera Zamiara Solange Leon
- Cal Fernando Bonilla
- Calderan Thiago R. A.
- Calik Bulent
- Calì Matteo
- Calleja-Lozano Rafael
- Calu Valentin
- Campanella Gaetano
- Candio Giulio
- Cannavera Alessandro
- Cantafio Stefano
- Caravaca Iban
- Caronna Roberto
- Casadei Massimiliano
- Catena Fausto
- Ceresoli Marco
- Cerioli Alessandra
- Cervellera Maurizio
- Chan Shannon Melissa
- Charalabopoulos Alexandros
- Chiara Osvaldo
- Chiarugi Massimo
- Chidumije Nnaemeka
- Chirletti Piero
- Chiuyari José Ríos
- Chooklin Serge
- Choudhary Hasham
- Chouillard Elie
- Chouliaras Christos
- Chuklin Serhii
- Ciabatti Giulia
- Cianci Pasquale
- Cicako Atea
- Cicuttin Enrico
- Cillara Nicola
- Cioffi Stefano
- Cioffi Stefano Piero Bernardo
- Ciuró Felipe Parej
- Clarizia Guglielmo
- Coccolini Federico
- Colak Elif
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- Trigiante Giuseppe
- Triguero-Cánovas Daniel
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- Troiano Raffaele
- Tsouknidas Ioannis
- Tur-Martínez Jaume
- Türkoğlu Mehmet Akif
- Tvaladze Anano
- Uccelli Matteo
- Ullah Syed Osama Zohaib
- Uymaz Derya Salim
- Uzunoglu Mustafa Yener
- Vailas Michail
- Valenzuela José Ignacio
- Vega Pilar Suárez
- Veroux Gastone
- Veroux Massimiliano
- Viganò Jacopo
- Villalabeitia Ibabe
- Vincenti Leonardo
- Virdis Francesco
- Visconti Diego
- Walędziak Maciej
- Wilson Michael
- Yusoff Ahmad Ramzi
- Zafar Noman
- Zago Marcello
- Zainab null
- Zarnescu Eugenia Claudia
- Zarnescu Narcis Octavian
- Zarnescu Narcis Octavian
- Zuin Matteo
- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- 01/01/2023
- Field of study
: The identification of high-risk patients in the early stages of infected pancreatic necrosis (IPN) is critical, because it could help the clinicians to adopt more effective management strategies. We conducted a post hoc analysis of the MANCTRA-1 international study to assess the association between clinical risk factors and mortality among adult patients with IPN. Univariable and multivariable logistic regression models were used to identify prognostic factors of mortality. We identified 247 consecutive patients with IPN hospitalised between January 2019 and December 2020. History of uncontrolled arterial hypertension (p = 0.032; 95% CI 1.135-15.882; aOR 4.245), qSOFA (p = 0.005; 95% CI 1.359-5.879; aOR 2.828), renal failure (p = 0.022; 95% CI 1.138-5.442; aOR 2.489), and haemodynamic failure (p = 0.018; 95% CI 1.184-5.978; aOR 2.661), were identified as independent predictors of mortality in IPN patients. Cholangitis (p = 0.003; 95% CI 1.598-9.930; aOR 3.983), abdominal compartment syndrome (p = 0.032; 95% CI 1.090-6.967; aOR 2.735), and gastrointestinal/intra-abdominal bleeding (p = 0.009; 95% CI 1.286-5.712; aOR 2.710) were independently associated with the risk of mortality. Upfront open surgical necrosectomy was strongly associated with the risk of mortality (p < 0.001; 95% CI 1.912-7.442; aOR 3.772), whereas endoscopic drainage of pancreatic necrosis (p = 0.018; 95% CI 0.138-0.834; aOR 0.339) and enteral nutrition (p = 0.003; 95% CI 0.143-0.716; aOR 0.320) were found as protective factors. Organ failure, acute cholangitis, and upfront open surgical necrosectomy were the most significant predictors of mortality. Our study confirmed that, even in a subgroup of particularly ill patients such as those with IPN, upfront open surgery should be avoided as much as possible. Study protocol registered in ClinicalTrials.Gov (I.D. Number NCT04747990)
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- 'Elsevier BV'
- Publication date
- 01/01/2014
- Field of study
How Many Varieties of Capitalism? Comparing the Comparative Institutional Analyses of Capitalist Diversity
- Author
- Alexander Gerschenkron
- Alfred D Chandler
- Andrew Shonfi Eld
- Arndt / Malcom Sorge
- Arndt / Wolfgang Sorge
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- Arndt Sorge
- Arthur Gould
- Bernhard / Jelle Ebbinghaus
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- Bob Hanck�
- Britta Rehder
- Bruno Amable
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- Christel
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- Colin Crouch
- D Rueda
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- Erik Bergl�f
- Francis G Castles
- Fritz Scharpf
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- Gary Herrigel
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- Gregory Jackson
- G�sta Esping-Andersen
- Harvey Leibenstein
- Herbert Kitschelt
- Horst / Michael Kern
- Immanual Wallerstein
- Isabela Mares
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- Masahiko Aoki
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- Michel Albert
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- Nicole Biggart
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- Paulette Kurzer
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- Peter A Hall
- Peter A Hall
- Peter Katzenstein
- Richard Deeg
- Richard Deeg
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- Richard Whitley
- Robert / Toshio Boyer
- Robert Boyer
- Robert Boyer
- Robert E Goodin
- Ron Bean
- Ronald Dore
- Ronald J Gilson
- Rondo Cameron
- Rudolf Hilferding
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- Sigurt Vitols
- Sigurt Vitols
- Simeon Djankov
- Stanley W Black
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- Yamamura
- Zachary Taylor
- Publication venue
- 'Elsevier BV'
- Publication date
- 01/01/2006
- Field of study
Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries
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- Abad-Motos A.
- Abbas A.M.
- Abbas M.
- Abbasi M.
- Abbott T.
- Abdalaal I.
- Abdel-Galil K.
- Abdelemam R.
- Abdelgawad A.
- Abdelkarim M.
- Abdelkhalek M.
- Abdelmageed A.
- Abdelmawgoud S.
- Abdelmohsen S.
- Abdelrahman A.S.
- Abdelrahman M.
- Abdelwahab K.
- Abdou H.
- Abdulai D.R.
- Abdulkhaleq M.
- Abdullah B.
- Abdulsalam K.
- Abdulsalam S.
- Abdur-Rahman L.
- Abdus-Salam R.
- Abdussalam H.O.
- Abebrese J.T.
- Abeldaño A.
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- Šantak G.
- Šimko K.
- Žatecký J.
- Publication venue
- Oxford University Press (OUP)
- Publication date
- 01/07/2023
- Field of study
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
Recommended from our members
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- Aali Amirali
- Ababneh Hazim S
- Abate Yohannes Habtegiorgis
- Abbafati Cristiana
- Abbasgholizadeh Rouzbeh
- Abbasi-Kangevari Mohsen
- Abbasian Mohammadreza
- Abbastabar Hedayat
- Abd ElHafeez Samar
- Abd-Elsalam Sherief
- Abdelmasseh Michael
- Abdelwahab Ahmed
- Abdollahi Mohammad
- Abdollahifar Mohammad-Amin
- Abdoun Meriem
- Abdulah Deldar Morad
- Abdullahi Auwal
- Abebe Mesfin
- Abebe Samrawit Shawel
- Abedi Aidin
- Abegaz Kedir Hussein
- Abhilash E S
- Abidi Hassan
- Abiodun Olumide
- Aboagye Richard Gyan
- Abolhassani Hassan
- Abolmaali Meysam
- Abouzid Mohamed
- Aboye Girma Beressa
- Abreu Lucas Guimarães
- Abrha Woldu Aberhe
- Abtahi Dariush
- Abu Rumeileh Samir
- Abu-Gharbieh Eman
- Abu-Rmeileh Niveen ME
- Abu-Zaid Ahmed
- Abualruz Hasan
- Abubakar Bilyaminu
- Aburuz Salahdein
- Accrombessi Manfred Mario Kokou
- Adal Tadele Girum
- Adamu Abdu A
- Addo Isaac Yeboah
- Addolorato Giovanni
- Adebiyi Akindele Olupelumi
- Adekanmbi Victor
- Adepoju Abiola Victor
- Adetunji Charles Oluwaseun
- Adetunji Juliana Bunmi
- Adeyeoluwa Temitayo Esther
- Adeyinka Daniel Adedayo
- Adeyomoye Olorunsola Israel
- Admass Biruk Adie Adie
- Adnani Qorinah Estiningtyas Sakilah
- Adra Saryia
- Afolabi Aanuoluwapo Adeyimika
- Afzal Muhammad Sohail
- Afzal Saira
- Agampodi Suneth Buddhika
- Agasthi Pradyumna
- Aggarwal Manik
- Aghamiri Shahin
- Agide Feleke Doyore
- Agodi Antonella
- Agrawal Anurag
- Agyemang-Duah Williams
- Ahinkorah Bright Opoku
- Ahmad Aqeel
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- Al Hasan Syed Mahfuz
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- Xu Xiaoyue
- Xu Yvonne Yiru
- Yadollahpour Ali
- Yamagishi Kazumasa
- Yang Danting
- Yang Lin
- Yano Yuichiro
- Yao Yao
- Yaribeygi Habib
- Ye Pengpeng
- Yehualashet Sisay Shewasinad
- Yesiltepe Metin
- Yesuf Subah Abderehim
- Yezli Saber
- Yi Siyan
- Yigezu Amanuel
- Yip Paul
- Yismaw Malede Berihun
- Yismaw Yazachew
- Yiğit Arzu
- Yiğit Vahit
- Yon Dong Keon
- Yonemoto Naohiro
- Yoon Seok-Jun
- You Yuyi
- Younis Mustafa Z
- Yousefi Zabihollah
- Yu Chuanhua
- Yu Yong
- Yuh Faith H
- Zadey Siddhesh
- Zadnik Vesna
- Zafari Nima
- Zakham Fathiah
- Zaki Nazar
- Zaman Sojib Bin
- Zamora Nelson
- Zand Ramin
- Zangiabadian Moein
- Zar Heather J
- Zare Iman
- Zarrintan Armin
- Zeariya Mohammed G M
- Zeinali Zahra
- Zhang Haijun
- Zhang Jianrong
- Zhang Jingya
- Zhang Liqun
- Zhang Yunquan
- Zhang Zhi-Jiang
- Zhao Hanqing
- Zhong Chenwen
- Zhou Juexiao
- Zhu Bin
- Zhu Lei
- Ziafati Makan
- Zielińska Magdalena
- Zitoun Osama A
- Zoladl Mohammad
- Zou Zhiyong
- Zuhlke Liesl J
- Zumla Alimuddin
- Zweck Elric
- Zyoud Samer H
- Ärnlöv Johan
- Šekerija Mario
- Publication venue
- Elsevier
- Publication date
- 03/04/2024
- Field of study
BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation
Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries
- Author
- Abad-Motos Ane
- Abbas Ahmed M.
- Abbas Mostafa
- Abbasi Mujeeb
- Abbott Tom
- Abd Karim Muhammad Fairuz Shah
- Abdalaal Ibrahim
- Abdel-Galil Khalid
- Abdelemam Rania
- Abdelgawad Abdalrahman
- Abdelkarim Maryam
- Abdelkhalek Mohamed
- Abdelmageed Abdelfatah
- Abdelmawgoud Sherif
- Abdelmohsen Sarah
- Abdelrahman Ahmed Saber
- Abdelrahman Mostafa
- Abdelwahab Khaled
- Abdou Hossam
- Abdulai Darling Ramatu
- Abdulkhaleq Marwa
- Abdullah Bahiyah
- Abdulsalam Khalifa
- Abdulsalam Shuaib
- Abdur-Rahman Lukman
- Abdus-Salam Rukiyat
- Abdussalam Hameedat Opeyemi
- Abebrese John Tabiri
- Abeldaño Ariel
- Abou-Khalil Jad
- Abou-Taleb Hisham
- Abozid Anwaar
- Abozied Hesham
- Abrate Alberto
- Abu-Zaid Ahmed
- Abubakar Mohammed Kabir
- Abud Burçin
- Abuzaid Mohammed
- Adam Albushra Altayeb
- Adamina Michel
- Adamou Harissou
- Adamu Auwal
- Adamu Kabir Musa
- Adanu Kekeli
- Adebara Idowu
- Adebola Oluwaseyi
- Ademuyiwa Adesoji
- Adeniran Abiodun
- Adepiti Akinfolarin
- Aderogba Adeleke Akeem
- Adesunkanmi Abdulhafiz
- Adeyeye Ademola
- Adisa Adewale
- Adjeso Theophilus Justus Kofi
- Ads Adel Mohamed
- Ads Alaa Mohamed
- Adu-Aryee Nii Armah
- Adumah Collins
- Afzal Irrum
- Agapov Mikhail
- Agarwal Gaurav
- Agarwal Ravi
- Agbeko Anita Eseenam
- Agbeno Evans Kofi
- Agbonrofo Peter
- Agboola Oluseyi
- Aggarwal Gaurav
- Aghadi Ifeanyi
- Aghtarafi Natasha
- Agrawal Amit
- Agresta Ferdinando
- Aguado Héctor J.
- Aguilera-Arevalo Maria-Lorena
- Aherne Thomas
- Ahmad Aline
- Ahmad Maleeha
- Ahmad Misbahu
- Ahmad Sarwat
- Ahmad Shahzaib
- Ahmad Shoaib
- Ahmed Hayat Tarig Abdelhafiz
- Ahmed Khalid
- Ahmed Sharwany
- Ahmed Shima
- Ahmed Usama
- Aisuodionoe-Shadrach Oseremen
- Aitken Sarah
- Ajenifuja Kayode
- Ajiya Abdulrazak
- Akeel Nouf
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- Su Yu-Xiong
- Suarez Sara Busto
- Subramani Yamini
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- Sue-Chue-Lam Colin
- Suer Muhammed Salih
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- Sultania Mahesh
- Sundarraju Shalini
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- Wong Enoch
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- Wong Ho Ying Flora
- Wong Kai Yuen
- Wormald Justin
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- Wright Joshua
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- Yebes Alvaro
- Yenli Edwin Mwintiereh Ta-Ang
- Yeoh Tien
- Yeung Justin
- Yiallourou Anneza
- Yigit Banu
- Yildirim Asif
- Yim Guang
- Yiu Andrew
- Yonekura Hiroshi
- Yotsov Tsanko
- Younis Muhammad Umar
- Yunus Alif
- Yusefi Hossein
- Zabaleta Jon
- Zabkiewicz Catheriner
- Zaccaria Giulia
- Zacharia Bincy
- Zafar Syed Nabeel
- Zago Mauro
- Zaheen Zakia
- Zahid Zahra
- Zaimis Tilemachos
- Zakaria Andee Dzulkarnaen
- Zambon Martina
- Zamora Lindsey
- Zampogna Biagio
- Zancana Giuseppa
- Zani Augusto
- Zanin Luca
- Zanini Nicola
- Zapardiel Ignacio
- Zapata Carlos Shiraishi
- Zarif Pierre
- Zaránd Attila
- Zehnder Philipp
- Zenger Serkan
- Zenha Horácio
- Zhu Michael Z. L.
- Ziemann Sebastian
- Zimak Danijela Mrazovac
- Zimak Zoran
- Zivkovic Dragana
- Zizzo Maurizio
- Zucker Benjamin
- Zwain Yasir
- Zyskowski Michael
- Ávila Clara Castro
- Älgå Andreas
- Çakici Mehmet Çaǧlar
- Çelik Enes
- Çelik Meryem Nur
- Özçay Necdet
- Şevik Hüsnü
- Šantak Goran
- Šimko Kristián
- Žatecký Jan
- Publication venue
- 'Oxford University Press (OUP)'
- Publication date
- 01/01/2023
- Field of study
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