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

The effectiveness of joint consultation and organisational outcomes A study of joint labour committees in Bahrain

SIGLEAvailable from British Library Document Supply Centre-DSC:DXN033743 / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Multivariate statistical process control charts based on the approximate sequential ?2 test

Similar to the univariate CUSUM chart, a multivariate CUSUM (MCUSUM) chart can be designed to detect a particular size of the mean shift optimally based on the scheme of a sequential likelihood ratio test for the noncentrality parameter. However, in multivariate case, the probability ratio of a sequential test is intractable mathematically and the test statistic based on the ratio does not have a closed form expression which makes it impractical for real application. We drive an approximate log-likelihood ratio and propose a multivariate statistical process control chart based on a sequential ?2 test to detect a change in the noncentrality parameter. The statistical properties of the proposed test statistic are explored. The average runs length (ARL) performance of the proposed charts is compared with other MCUSUM charts for process mean monitoring. The experimental results reveal that the proposed charts achieve superior, both zero-state and steady-state, ARL performance over a wide range of mean shifts, especially when the dimension of measurements is large.Qatar National Research Fund (QNRF) [grant number NPRP 08-323-2-116]Scopu

New Anti-inflammatory Sterols from the Red Sea Sponges Scalarispongia aqabaensis and Callyspongia siphonella

Bioassay-guided fractionation of the anti-inflammation fractions of the Red Sea sponges Scalarispongia aqabaensis and Callyspongia siphonella yielded two new sterols from chloroform fractions of methanol extracts, namely scalaristerol (5α,8β- dihydroxycholest-6-en-3β -ol) (1) from Scalarispongia aqabaensis, and callysterol (ergosta-5,11-dien-3β-ol) (2) from Callyspongia siphonella. Structure determination was based on extensive NMR studies and mass spectrometry. The antiinflammatory activity of compounds 1 and 2 was assessed using the rat-hind paw edema method and by study of their effect on the release of O2 - and TXB2 from LPS-activated rat neonatal microglia

Bayesian framework for fault variable identification

In most manufacturing processes, identifying the faulty process variables that may lead to process changes is crucial for quality engineers and practitioners. There are several parametric procedures for identifying faulty variables with the assumption that they follow multivariate normal distributions. However, in practice, the normality assumption restricts the applicability of such procedures in identifying the faulty variables. In addition, conventional procedures for fault identification are often computationally expensive, especially in high-dimensional processes. Therefore, this article proposes a data-driven Bayesian approach for fault identification that addresses the limitations posed by the normality assumption. The proposed approach is computationally efficient for high-dimensional data compared with existing approaches. Experimental results with various simulation studies and real-life data sets demonstrate the effectiveness of the proposed procedure. - 2018, - 2018 American Society for Quality.This article was made possible by the support of NPRP 5-364-2-142 and NPRP 7-1040-2-393 grants from Qatar National Research Fund (QNRF) and NRF-2015R1C1A1A01051487 from the National Research Foundation of Korea.Scopu

Inter-cluster synchronization scheme for femtocell network

Femtocell is for indoor coverage, and cannot use a GPS antenna for time synchronization. High-precision crystal oscillators can solve the timing problem, but they are often too expensive for consumer grade devices. Since fBS and macrocell Base Station (mBS) network operate on the same frequency under a licensed spectrum fBS network can interfere with the macrocell network. In addition, fBSs can also interfere with each other if multiple units are in close proximity. In some cases, conflicting base stations may simultaneously raise transmit power in order to improve signal quality, thereby creating some interference. Furthermore, in a flat fBS structured network using IEEE 1588 synchronization algorithm and fBS-fBS synchronization scheme creates offset and frequency error which results inaccurate synchronization. However, in this paper an inter-cluster synchronization scheme is proposed in order to reduce offset and frequency error (skew) to achieve precise synchronization in fBS neighbor nodes. The analytical result shows that the proposed scheme is able to reduce the offset and skew significantly through inter-cluster synchronization ultimately increases synchronization accuracy. Therefore, achieved synchronization accuracy is 90% higher than the existing MS-assisted schemes

Design, Synthesis, Pharmacological Evaluation and DFT Investigation of New Bioactive Unsymmetrical Bi-Functional Ligand

Compounds with more than one bioactive motif become of great interest. In this regard, a new tridentate 1,2-unsymmetrical ligand consists of flexible and rigid bioactive arms spaced by benzene ring in an ortho position designed to form a bifunctional molecule. The 2-((3-(pyridin-2-yl)-1H-pyrazol-1-yl)methyl)benzonitrile (PPMB) synthesized under phase transfer reaction and characterized using 1H-NMR and mass spectroscopy and studied as potent kinase inhibitors. Theoretically, the molecule structure was investigated at the B3LYP/6-311++G(d,p) level of theory in the gas phase and revealed that all bond lengths and bond angles within the accepted limit. The frontier molecular orbitals (FMO) energies (HOMO and LUMO), energy gap, dipole moment, chemical softness and chemical hardness were calculated. Pharmacologically, the ligand activity was investigated in silico using SWISS ADME. Furthermore, the compound was docked into the transforming growth factor (TGF) beta type I receptor kinase active site to evaluate the ability of ligand as a kinase inhibitor. Keywords: DFT, pyrazolyl-pyridine, physiochemical, properties molecular docking, bioactive molecules, unsymmetrical ligand