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

Occurrence of Campylobacter in the genitals of teaser bulls maintained at an embryo transfer center

Em central de transferência de embriões, após os procedimentos de reconhecimento do cio em 37 vacas receptoras, através de quatro rufiões vasectomizados, observou-se que 83% delas apresentavam retorno ao cio e algum corrimento serofibrinoso. Nos exames bacteriológicos realizados nos lavados prepuciais dos rufiões foi isolado o Campylobacter fetus subsp. venerealis em todos, fato que, analisado associadamente com o retorno ao cio das vacas receptoras, é indicativo da ocorrência de campilobacteriose no plantel. Essa ocorrência demonstra a necessidade de medidas eficazes de planejamento de saúde animal, pela utilização de rufiões com desvio lateral do pênis. Uma vez impossibilitado o contato sexual, seria impedida a transmissão do agente durante o coito. Torna-se imperioso consignar que a prática da prevenção racional de enfermidades continua sendo o procedimento mais econômico para uma produtividade animal mais rentável

Occurrence of Campylobacter in the genitals of teaser bulls maintained at an embryo transfer center

Em central de transferência de embriões, após os procedimentos de reconhecimento do cio em 37 vacas receptoras, através de quatro rufiões vasectomizados, observou-se que 83% delas apresentavam retorno ao cio e algum corrimento serofibrinoso. Nos exames bacteriológicos realizados nos lavados prepuciais dos rufiões foi isolado o Campylobacter fetus subsp. venerealis em todos, fato que, analisado associadamente com o retorno ao cio das vacas receptoras, é indicativo da ocorrência de campilobacteriose no plantel. Essa ocorrência demonstra a necessidade de medidas eficazes de planejamento de saúde animal, pela utilização de rufiões com desvio lateral do pênis. Uma vez impossibilitado o contato sexual, seria impedida a transmissão do agente durante o coito. Torna-se imperioso consignar que a prática da prevenção racional de enfermidades continua sendo o procedimento mais econômico para uma produtividade animal mais rentável

Parallels Between Plants And Animals In The Production And Molecular Targets Of Nitric Oxide

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Dayside induced magnetic field of the ionosphere of Mars

International audienceThe Mars Advanced Radar for Subsurface and Ionospheric Sounding (MARSIS) onboard the Mars Express spacecraft has occasionally displayed surprising features. One such feature is the occurrence of a series of broadband, low-frequency echoes at equally spaced delay times after the sounder transmitter pulse. The interval between the echoes has been shown to be at the cyclotron period of electrons orbiting in the local magnetic field. The electrons are believed to be accelerated by the large voltages applied to the antenna by the sounder transmitter. Measurements of the period of these “electron cyclotron echoes” provide a simple technique for determining the magnitude of the magnetic field near the spacecraft. These measurements are particularly useful because Mars Express carries no magnetometer, so this is the only method available for measuring the magnetic field magnitude. Using this technique, results are presented showing the large scale structure of the draped field inside the magnetic pile-up boundary. The magnitude of the draped field is shown to vary from about 40 nT at a solar zenith angle of about 25°, to about 25 nT at a solar zenith angle of 90°. The results compare favorably with similar results from the Mars Global Surveyor spacecraft. A fitting technique is developed to derive the vector direction and magnitude of the draped magnetic field in cases where the spacecraft passes through regions with significant variation in the crustal field. The magnetic field directions are consistent with current knowledge of the draping geometry of the magnetic field around Mars