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

Pomological traits of some selected quince types

This study was carried out in the Pozanti Agricultural Research and Application Centre of the University of Çukurova to determine some qualitative traits of promising quince types which were selected in different regions of Turkey, at Pozanti ecological conditions. Kalecik (0612), Ekmek (2604 and 2609), Cengelköy (2601), Şeker (3403), Limon (0514), Bardacik (3704), Altin Ayva (3401), Tekkes (0156), Istanbul (0518), Yerli (1918) and Eşme (5401 and 5403) were used as plant material. Some pomological traits, amounts of tannins and difficulty of swallow traits of these quince types were determined. According to the results, the largest fruits were obtained from Bardakci, Istanbul, Limon and Seker quince types respectively and the smallest fruits were obtained from Altin Ayva. On the other hand, difficulty of swallow traits were least in Seker, Limon, Tekkes and Eşme (5401) quince types respectively and the highest difficulty of swallow trait was obtained from Cengelköy

Association of busulfan exposure with survival and toxicity after haemopoietic cell transplantation in children and young adults: a multicentre, retrospective cohort analysis

Personalised Therapeutic

Association of busulfan exposure with survival and toxicity after haemopoietic cell transplantation in children and young adults: a multicentre, retrospective cohort analysis

Personalised Therapeutic