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

Effects of the Variants of Activin Receptor-like Kinase-1 and 2 on the Lipid Profile of Patients with Coronary Heart Disease

Introduction: Coronary heart disease (CHD) due to atherosclerosis is a multifactorial disease with high morbidity caused by interaction of various genetic and environmental factors. Hyperlipidemia which is accepted as the most important risk factor for atherosclerosis; characterized by high concentration of low density lipoprotein (LDL)-cholesterol (LDL-C) and low concentration of high density lipoprotein (HDL)-cholesterol (HDL-C). Epidemiological studies prove the inverse relationship between HDL-C levels and CHD. Apolipoprotein A1, the major protein of HDL, is secreted as proprotein and then cleaved by C-terminal procollagen endoproteinase/bone morphogenetic protein-1 (BMP-1). Reporting of the role of BMP receptors in lipoprotein metabolism indicates that variations in these genes may be important. However, there are no studies in the literature about the variations in type I receptors for activin receptor-like kinase (ALK) 1 and ALK2 and its effects on lipid profile. In this study, it was aimed to determine the role of the gene variants of ALK1 (Q292P ve S333G) and ALK2 (R206H) receptors in the development of CHD and their effects on serum lipoprotein levels

BIOACCUMULATION OF CADMIUM BY NILE TILAPIA Oreochromis niloticus (L.) IN THE PRESENCE OF GREEN ALGAE Cladophora glomerata (L.) Kutz.

WOS: 000272582500010Accumulation of cadmium (Cd) was determined in the muscle and gill tissues of Nile tilapia Oreochromis niloticus (L.) exposed to sublethal concentrations of Cd (0.1 and 1.0 mg/L) under laboratory conditions for 15 and 30 days, in the absence or presence of green algae Cladophora glomerata (L.) Kutz. Results showed that muscles, irrespective of treatments, accumulated less Cd than gills. Cd accumulation significantly increased in both the tissues in treatment groups as compared to control groups (p0.05). Presence of green algae did not influence accumulation of Cd in muscle. But Cd accumulation was significantly reduced in gills, in the presence of green algae, in all treatments groups, except in 0.1 mg/L Cd exposure for 15 days. In the presence of green algae, the reduced Cd accumulation in gills might be due to its uptake from the medium by the algae.University of DicleDicle University [DUAPK-03-FF-59]The authors are thankful to University of Dicle for its financial support (Grant no. DUAPK-03-FF-59), University of Cukurova for providing fish samples, Prof. A. Kavraj, (University of Kalyani, West Bengal, India), and anonymous reviewers for their valuable suggestions and critical evaluation of the manuscript

Identification of emotion in a dichotic listening task: event-related brain potential and behavioral findings

The lateralization of emotion perception has been examined using stimuli in both auditory and visual modalities. Studies using dichotic stimuli have generally supported the hypothesis of right-hemisphere dominance for emotion perception, whereas studies of facial and verbal emotion perception have provided evidence for the right-hemisphere and valence hypotheses. A dichotic target detection task was developed to enable acquisition of event-related potentials (ERP) from subjects engaged in emotion detection. Nonsense syllables (e.g., ba, pa) stated in seven different emotional intonations were dichotically presented to 24 young adults, in a target detection task during four separate blocks (target emotions: happiness, interest, anger, or sadness). Accuracy and reaction time and ERP measures were also collected. ERPs were recorded from 14 scalp electrodes with a nose reference and quantified for N100, sustained negativity, late positivity, and slow wave. Significantly greater left-than right-ear accuracy was obtained for the identification of target prosodic emotion. Hemispheric asymmetries of N100 and sustained negativity This study is based on a doctoral dissertation conducted by the first author for Queens College and the Graduate School of the City University of New York. Partial support was provided by National Institutes of Mental Health Grants MH36295 (GB) and MH42172 ( JB). We are grateful to Drs. H. Ehrlichman, R. Johnson, and H. Sackeim for their insightful comments as members of the dissertation committee; to Dr. J. Towey for his contributions and support; to Dr. J. Welkowitz for consultation regarding aspects of methodology; to Dr. L. K. Obler for access to equipment during the stimulus development phase; and to D. Schechter for access to the normal subject pool at the New York State Psychiatric Institute. Address were found, with left-hemisphere amplitudes greater than right-hemisphere amplitudes. These ERP asymmetries were not significantly correlated with the left-ear dichotic advantage and may be related more to early phonetic processing than to emotion perception. Since the behavioral evidence supports the right-hemisphere hypothesis for emotion perception, behavioral and ERP asymmetries evident in this task reflect separable patterns of brain lateralization

A Novel Platelet Concentrate: Titanium-Prepared Platelet-Rich Fibrin

We developed a new product called titanium-prepared platelet-rich fibrin (T-PRF). The T-PRF method is based on the hypothesis that titanium may be more effective in activating platelets than the silica activators used with glass tubes in Chouckroun's leukocyte- and platelet-rich fibrin (L-PRF) method. In this study, we aimed to define the structural characteristics of T-PRF and compare it with L-PRF. Blood samples were collected from 10 healthy male volunteers. The blood samples were drawn using a syringe. Nine milliliters was transferred to a dry glass tube, and 9 mL was transferred to a titanium tube. Half of each clot (i.e., the blood that was clotted using T-PRF or L-PRF) was processed with a scanning electron microscope (SEM). The other half of each clot was processed for fluorescence microscopy analysis and light microscopy analysis. The T-PRF samples seemed to have a highly organized network with continuous integrity compared to the other L-PRF samples. Histomorphometric analysis showed that T-PRF fibrin network covers larger area than L-PRF fibrin network; also fibrin seemed thicker in the T-PRF samples. This is the first human study to define T-PRF as an autogenous leukocyte-and platelet-rich fibrin product. The platelet activation by titanium seems to offer some high characteristics to T-PRF

Illness perception of dropout patients followed up at bipolar outpatient clinic, Turkey

Dropout is a common problem in the treatment of psychiatric illnesses including bipolar disorders (BD). The aim of the present study is to investigate illness perceptions of dropout patients with BD. A cross sectional study was done on the participants who attended the Mood Disorder Outpatient Clinic at least 3 times from January 2003 through June 2008, and then failed to attend clinic till to the last one year, 2009, determined as dropout. Thirty-nine dropout patients and 39 attendent patients with BD were recruited for this study. A sociodemographic form and brief illness perception questionnaire were used to capture data. The main reasons of patients with BD for dropout were difficulties of transport (31%), to visit another doctor (26%), giving up drugs (13%) and low education level (59%) is significant for dropout patients. The dropout patients reported that their illness did not critically influence their lives, their treatment had failed to control their illnesses, they had no symptoms, and that their illness did not emotionally affect them. In conclusion, the nonattendance of patients with serious mental illness can result in non-compliance of therapeutic drug regimens, and a recurrence of the appearance symptoms. The perception of illness in dropout patients with BD may be important for understanding and preventing nonattendance. (C) 2015 Elsevier B.V. All rights reserved

Demographic and Clinical Findings of Cerebral Palsy Patients in Istanbul: A Multicenter Study

Objective: The objective of this study is to identify epidemiological characteristics of patients with cerebral palsy (CP) in Istanbul, including demographic information, clinical types, risk factors, and some clinical features