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

Influence of Dzyaloshinskii–Moriya interaction and perpendicular anisotropy on spin waves propagation in stripe domain patterns and spin spirals

Abstract Texture-based magnonics focuses on the utilization of spin waves in magnetization textures to process information. Using micromagnetic simulations, we study how (1) the dynamic magnetic susceptibility, (2) dispersion relations, and (3) the equilibrium magnetic configurations in periodic magnetization textures in a ultrathin ferromagnetic film in remanence depend on the values of the Dzyaloshinskii–Moriya interaction and the perpendicular magnetocrystalline anisotropy. We observe that for large Dzyaloshinskii–Moriya interaction values, spin spirals with periods of tens of nanometers are the preferred state; for small Dzyaloshinskii–Moriya interaction values and large anisotropies, stripe domain patterns with over a thousand times larger period are preferable. We observe and explain the selectivity of the excitation of resonant modes by a linearly polarized microwave field. We study the propagation of spin waves along and perpendicular to the direction of the periodicity. For propagation along the direction of the periodicity, we observe a bandgap that closes and reopens, which is accompanied by a swap in the order of the bands. For waves propagating in the perpendicular direction, some modes can be used for unidirectional channeling of spin waves. Overall, our findings are promising in sensing and signal processing applications and explain the fundamental properties of periodic magnetization textures

Platinum overlayer-induced changes of magnetic and magneto-optical properties of ultrathin Co layer

Magneto-optical and magnetic properties of Au/Co-wedge/Pt-wedge/Au were investigated as functions of component layer thicknesses. The remanence, coercivity field and saturation of both rotation and ellipticity were deduced from the shape analysis of the magnetic hysteresis loops measured at different positions of the sample by means of the magneto-optical polar Kerr effect magnetometer. For low thickness of platinum overlayer Co-thickness range with perpendicular anisotropy increases, and very high peak of coercivity field was observed. These phenomena are explained in terms of the ternary Co–Pt–Au alloy occurrence with large anisotropy at interface

Efficacy of Flotetuzumab in Combination with Cytarabine in Patient-Derived Xenograft Models of Pediatric Acute Myeloid Leukemia

Children with acute myeloid leukemia (AML) have a poor prognosis despite the intensification of chemotherapy. Future efforts to improve outcomes should focus on more precise targeting of leukemia cells. CD123, or IL3RA, is expressed on the surface of nearly all pediatric AML samples and is a high-priority target for immunotherapy. The efficacy of an investigational dual-affinity retargeting antibody (DART) molecule (CD123 × CD3; MGD006 or flotetuzumab) was assessed in two distinct patient-derived xenograft (PDX) models of pediatric AML. MGD006 simultaneously binds to CD123 on target cells and CD3 on effector T cells, thereby activating T cells and redirecting them to induce cytotoxicity in target cells. The concurrent treatment of cytarabine and MGD006 was performed to determine the effect of cytarabine on T-cell counts and MGD006 activity. Treatment with MGD006 along with an allogeneic human T-cell infusion to act as effector cells induced durable responses in both PDX models, with CD123 positivity. This effect was sustained in mice treated with a combination of MGD006 and cytarabine in the presence of T cells. MGD006 enhanced T-cell proliferation and decreased the burden of AML blasts in the peripheral blood with or without cytarabine treatment. These data demonstrate the efficacy of MGD006 in prolonging survival in pediatric AML PDX models in the presence of effector T cells and show that the inclusion of cytarabine in the treatment regimen does not interfere with MGD006 activity