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

Non-Invasive Methods for Predicting the Quality of Processed Horticultural Food Products, with Emphasis on Dried Powders, Juices and Oils: A Review

This review covers recent developments in the field of non-invasive techniques for the quality assessment of processed horticultural products over the past decade. The concept of quality and various quality characteristics related to evaluating processed horticultural products are detailed. A brief overview of non-invasive methods, including spectroscopic techniques, nuclear magnetic resonance, and hyperspectral imaging techniques, is presented. This review highlights their application to predict quality attributes of different processed horticultural products (e.g., powders, juices, and oils). A concise summary of their potential commercial application for quality assessment, control, and monitoring of processed agricultural products is provided. Finally, we discuss their limitations and highlight other emerging non-invasive techniques applicable for monitoring and evaluating the quality attributes of processed horticultural products. Our findings suggest that infrared spectroscopy (both near and mid) has been the preferred choice for the non-invasive assessment of processed horticultural products, such as juices, oils, and powders, and can be adapted for on-line quality control. Raman spectroscopy has shown potential in the analysis of powdered products. However, imaging techniques, such as hyperspectral imaging and X-ray computed tomography, require improvement on data acquisition, processing times, and reduction in the cost and size of the devices so that they can be adopted for on-line measurements at processing facilities. Overall, this review suggests that non-invasive techniques have the potential for industrial application and can be used for quality assessment

Non-invasive measurement of quality attributes of processed pomegranate products

Thesis (MEng)--Stellenbosch University, 2020.ENGLISH ABSTRACT: Pomegranate fruit has witnessed tremendous growth over the past decade in production, consumption, processing and research within South Africa. Currently, in order to provide value-addition and effective utilisation of pomegranate fruit parts, the edible portion has been processed by the food industry into various co-products such as juices, dried arils, seed oil and powders. The food processing industry is frequently confronted by new technological challenges to meet the increasing demand for quality assured processed products. This, however, has led to a shift in agribusiness reliance from subjective assessment of quality and authenticity to increasing adoption of objective, quantitative and non-invasive measurement. For pomegranates, non-invasive techniques such as X-ray computed tomography and infrared spectroscopy have successfully been used to evaluate postharvest rind disorders, quality attributes of whole fruit, and several of its co-products such as fresh arils and pomegranate juice. For processed agricultural and horticultural products, non-invasive techniques have been successfully used to evaluate and predict quality attributes related to juice, powders oils and minimally processed products. However, limited information on non-invasive techniques exist for evaluating different processed pomegranate co-products such as dried arils, powders and seed oil. Therefore, the aim of this research study was to develop non-invasive methods using infrared spectroscopy to predict the quality attributes of pomegranate co-products (dried arils and seed oil). Section I (Chapter 1) provides background information and the problem statement, including the aims and objectives of the research study. Chapter 2 provides a review of literature on non-invasive methods used to predict the quality attributes for different processed horticultural products with emphasis on juices, oils and powdered products and highlights potential research scientific gaps. Section II covers the application of infrared (FT-NIR and FT-MIR) spectroscopy in evaluating pomegranate co-products (dried arils and seed oil). In Chapter 3, Fourier-transform near infrared (FT-NIR) spectroscopy and associated chemometric analysis was used to evaluate quality attributes of dried pomegranate arils. This study compared two different regression techniques, namely partial least squares (PLS) and support vector machine (SVM), to develop calibration models over a spectral region of 800 – 2500 nm. Model development was based on pre-processing methods that yielded higher values of coefficient of determination (R2) and residual predictive deviation (RPD), and root mean square error of prediction (RMSEP). It was found that SVM could predict acidity (R2= 0.85, RMSEP = 0.04%, RPD = 2.50), redness (a ) colour attributes (R2 = 0.72, RMSEP = 1.82%, RPD = 1.71) and intensity (Chroma) (R2 = 0.70, RMSEP = 1.99%, RPD = 1.77). PLS regression also accurately predicted sensory attributes (pH, (R2 = 0.86, RMSEP = 0.13%, RPD = 2.38 and TSS:TA ratio, R2= 0.74, RMSEP = 1.68%, RPD = 1.68). These results suggest that SVM was better suited to evaluate the quality attributes of dried pomegranate arils. Chapter 4 (Section III) evaluated the quality of pomegranate seed oil by comparing two different spectrophotometers, namely; the Multipurpose Analyzer (MPA) in the FT-NIR spectral region of (12500 – 4000 cm1) and the Alpha ATR-FT-MIR in the spectral region of 4000 – 400 cm1. The MPA (FT-NIR) showed good prediction in the FT-NIR spectral region for total carotenoid content (R2 = 80.45, RMSEP = 0.0185 b-carotene/ mL oil, RPD = 2.28) and yellowness index (R2 = 53.19, RMSEP = 14.30%, RPD = 1.49). The Alpha (FT-IR) instrument in the FT-MIR spectral region provided good prediction for refractive index (R2 = 80.92, RMSEP = 0.0003%, RPD = 2.32) and prediction for peroxide value (R2 = 62.00, RMSEP = 3.88 meq O2/mL oil, RPD =1.62). In this study, FT-MIR spectroscopy provided better prediction statistics compared to than FT-NIR spectroscopy for evaluating the quality attributes of pomegranate oil. This research study has demonstrated that infrared spectroscopy and associated chemometric analysis has the ability to predict the quality attributes of pomegranate dried arils and seed oil.AFRIKAANSE OPSOMMING: Geen opsommingMaster

Pomegranate Quality Evaluation Using Non-Destructive Approaches: A Review

Pomegranate (Punica granatum L.) is one of the most healthful and popular fruits in the world. The increasing demand for pomegranate has resulted in it being processed into different food products and food supplements. Researchers over the years have shown interest in exploring non-destructive techniques as alternative approaches for quality assessment of the harvest at the on-farm point to the retail level. The approaches of non-destructive techniques are more efficient, inexpensive, faster and yield more accurate results. This paper provides a comprehensive review of recent applications of non-destructive technology for the quality evaluation of pomegranate fruit. Future trends and challenges of using non-destructive techniques for quality evaluation are highlighted in this review paper. Some of the highlighted techniques include computer vision, imaging-based approaches, spectroscopy-based approaches, the electronic nose and the hyperspectral imaging technique. Our findings show that most of the applications are focused on the grading of pomegranate fruit using machine vision systems and the electronic nose. Measurements of total soluble solids (TSS), titratable acidity (TA) and pH as well as other phytochemical quality attributes have also been reported. Value-added products of pomegranate fruit such as fresh-cut and dried arils, pomegranate juice and pomegranate seed oil have been non-destructively investigated for their numerous quality attributes. This information is expected to be useful not only for those in the grower/processing industries but also for other agro-food commodities