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

Indigenous ethnobotanical remedies practiced to cure feminine diseases in tribal communities of kashmir himalayas

Women’s reproductive cycles are very clinical and complex, having unwanted medical conditions. Himalayan Women have been trying to enhance their fertility and regulate their reproductive cycles throughout the history by practicing ethnomedicinal remedies, as they are reluctant to expose their feminine problems to doctors due to psychological, social and religious barriers. Present study reveals the ethnomedicinal recipes practiced by mountain women in Kashmir Himalayas for feminine diseases. Data was acquired by planned biological inventories, exclusive interviews and direct observations in the field. A total of 36 plants belonging to 27 families were recorded being practiced for feminine diseases in 43 different recipes. Major feminine diseases treated by ethnomedicine were menstrual disorders (32%); birth pain and bleeding (16%); Contraception and abortion (16%); enhancing fertility (9%), Sexual potency (9%) and Lactation (7%). Major plant parts utilized in recipes were roots (32%), whole plant (16%), leaves (16%), Seeds (9%), latex (7%) and fruit (7%). Decoctions (41%), raw plant parts (24%) and extracts (13%) were prevalent modes of ethnomedicinal remedies. 79.6% respondents were effectively involved in ethnomedicinal practices to treat feminine diseases. An increasing trend towards modern medical treatment was observed in younger generation correlated with higher education level. Paper discuses the ethnomedicinal treatment of feminine diseases in qualitative as well as quantitative methodology and elaborates how the local folklore can be used at regional levels to add new cures in feminine pharmacopeia

Evaluation of the Effectiveness of Employers and H&S Services in Relation to the COVID-19 System in Polish Manufacturing Companies

With the advent of the COVID-19 pandemic, companies had to adapt quickly to survive in the market. During this time, employers played a key role, along with employees involved in Occupational Health and Safety (OHS) activities, as they were responsible for implementing the recommendations of the European Commission. There is no unambiguous definition of OHS in Polish legislation. It is assumed that it is a set of rules defining the manner of performing work, and above all, a method of providing employees with working conditions so that their performance is safe and hygienic. Responsibility for the health and safety in the workplace is imposed on the employer by the legislature. Thus, effective health and safety training is an essential element of the success of any properly operating company. In the literature, no studies have been identified that evaluate the effectiveness of actions during the COVID-19 outbreak. The aim of the article is to present the actions of Polish employers along with their effectiveness assessment related to the protection of employees during the COVID-19 outbreak. The article presents a proposal for conducting remote OHS (Occupational Health and Safety) training using the platform Moodle. The created course was implemented during OHS training conducted in a selected manufacturing company. At its end, an evaluation of the course was carried out, and the collected opinions of training participants allowed the formulation of interesting conclusions, which became the contribution of this paper. The authors pay special attention to three main points of the work. The first is the form of training, which gives the possibility to conduct training at a distance while maintaining its effectiveness. The second important point is the mandatory feedback of the trainees, ensuring the possibility of continuous improvement and quality enhancement of both the program and the form of training. The evaluation was developed on the basis of the extended Kirkpatrick model, which is a completely new approach to OHS training evaluation. The third point emphasized by the authors is the possibility of precise adaptation of the training to other plants and even industries. Therefore, it can be concluded that the course developed by the authors is a very interesting and practical didactic tool with great implementation potential

Anatomical studies on water hyacinth (Eichhornia crassipes (Mart.) Solms) under the influence of textile wastewater

Water hyacinth (Eichhornia crassipes (Mart.) Solms) is a prolific free floating aquatic macrohpyte found in tropical and subtropical parts of the earth. The effects of pollutants from textile wastewater on the anatomy of the plant were studied. Water hyacinth exhibits hydrophytic adaptations which include reduced epidermis cells lacking cuticle in most cases, presence of large air spaces (7~50 μm), reduced vascular tissue and absorbing structures. Textile waste significantly affected the size of root cells. The presence of raphide crystals was noted in parenchyma cells of various organs in treated plants

Tannin phenotyping of the Vitaceae reveals a phylogenetic linkage of epigallocatechin in berries and leaves

International audienceBackground and AimsCondensed tannins, responsible for berry and wine astringency, may have been selected during grapevine domestication (Narduzzi et al., 2015). This work examines the phylogenetic distribution of condensed tannins throughout the Vitaceae phylogenetic tree.MethodsGreen berries and mature leaves of representative true-to-type members of the Vitaceae were collected before “véraison”, freeze-dried, pulverised, and condensed tannins measured following depolymerization by nucleophilic addition of 2-mercaptoethanol to the C4 of the flavan-3-ol units in an organic acidic medium. Reaction products were separated and quantitated by UPLC/DAD/MS.Key Results and ConclusionsThe original ability to incorporate epigallocatechin (EGC) into grapevine condensed tannins was lost independently in both the American and Eurasian/Asian branches of the Vitaceae, with exceptional cases of reversion to the ancestral EGC phenotype. This is particularly true in the genus Vitis, where we now find two radically distinct groups differing with respect to EGC content. While Vitis species from Asia are void of EGC, 50% of the New World Vitis harbour EGC. Interestingly, the presence of EGC is tightly coupled with the degree of leaf margin serration. Noticeably, the rare Asian EGC-forming species are phylogenetically close to Vitis vinifera, the only remnant representative of Vitis in Eurasia. Both the wild ancestral V. vinifera subsp. sylvestris as well as the domesticated V. vinifera subsp. sativa can accumulate EGC and activate galloylation biosynthesis that compete for photoassimilates and reductive power

Assessing potential dietary toxicity of heavy metals in selected vegetables and food crops

Heavy metals, such as cadmium, copper, lead, chromium and mercury, are important environmental pollutants, particularly in areas with high anthropogenic pressure. Their presence in the atmosphere, soil and water, even in traces can cause serious problems to all organisms, and heavy metal bioaccumulation in the food chain especially can be highly dangerous to human health. Heavy metals enter the human body mainly through two routes namely: inhalation and ingestion, ingestion being the main route of exposure to these elements in human population. Heavy metals intake by human populations through food chain has been reported in many countries. Soil threshold for heavy metal toxicity is an important factor affecting soil environmental capacity of heavy metal and determines heavy metal cumulative loading limits. For soil-plant system, heavy metal toxicity threshold is the highest permissible content in the soil (total or bioavailable concentration) that does not pose any phytotoxic effects or heavy metals in the edible parts of the crops does not exceed food hygiene standards. Factors affecting the thresholds of dietary toxicity of heavy metal in soil-crop system include: soil type which includes soil pH, organic matter content, clay mineral and other soil chemical and biochemical properties; and crop species or cultivars regulated by genetic basis for heavy metal transport and accumulation in plants. In addition, the interactions of soil-plant root-microbes play important roles in regulating heavy metal movement from soil to the edible parts of crops. Agronomic practices such as fertilizer and water managements as well as crop rotation system can affect bioavailability and crop accumulation of heavy metals, thus influencing the thresholds for assessing dietary toxicity of heavy metals in the food chain. This paper reviews the phytotoxic effects and bioaccumulation of heavy metals in vegetables and food crops and assesses soil heavy metal thresholds for potential dietary toxicity