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

Tax Portfolio Optimization of the Hotel Business Entity Based on Tax Control Criteria

Tax evasion is quite widespread in the hotel business activities in Russia. This fact does harm not only to the Russian economy as tourism is becoming one of the dynamically developing industries, but also to business entities since the lack of financial visibility contributes to internal thefts in these companies. Regular changes in the tax legislation associated with the growth of tax burden are taken hard by the enterprises of the hotel industry. This problem has become the most acute due to the fact that often companies involved into the hotel business falsify the key figures of financial and economic activity for the purpose of hiding the results of commercial activity in order to reduce or completely avoid paying taxes. The successful operation of the hotel business requires an appropriate tax management system. Tax portfolio development for the hotel business entity can become both a means of further business development and a source of onerous expenses. One of the key factors affecting the composition and amount of the tax portfolio is the use of tax alternatives. The main research goal of this study is to develop scientific and practical recommendations on risk-oriented management of the hotel business tax portfolio through the use of tax portfolio criteria. According to the goal, such objectives have been set and realized in the article as definition of institutional basis of tax control, a research of risk-oriented approach to tax portfolio management and identification of tax risks for any hotel business entity based on tax portfolio criteria

ANTIBACTERIAL EFFECT OF COLLOIDAL SOLUTIONS OF SILVER NANOPARTICLES ON MICROORGANISMS OF CEREAL CROPS

Due to the growing problem of decrease in the quality and biological safety of food raw materials and the food obtained from it, the increase in the measures for grain improvement as one of the main vegetable resources of food productions is a necessary condition in the modern food industry. A perspectively new way of providing biosafety of grain raw materials is the use of silver nanoparticles. The present work provides data on the inhibiting influence of silver colloidal solutions on the bacterial composition of microflora of the most demanded grain crops of wheat and rye. Various antimicrobial efficiency of influence of the chosen colloidal solutions "Adzhenta colloidal silver" and "Colloidal silver concentrate KND-S-K" within 24 and 144 hours after the processing of grain crops has been shown. Various influence of experimentally chosen concentrations of solutions of silver nanoparticles of 0.1 g/dm3 and 0.075 g/dm3 on the number of viable cells of grain bacteria has been described. An approximate mechanism of effect of colloidal solutions of silver nanoparticles on the bacterial cells ofmicroorganisms has been stated. A negative role of bacterium Bacillus subtilis in grain production has specially been noted. Their identification in grain crops has been performed and measures for effective destruction of them in grain by means of silver nanoparticles have been proposed. The current data can be used for providing biological safety of grain and an effective solution of the problems on its processing for the purpose of manufacturing of quality products