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

Design des surfaces texturées hétéro-chimiques pour le contrôle des propriétés de rupture des interfaces de contact

International audienc

Design des surfaces texturées hétéro-chimiques pour le contrôle des propriétés de rupture des interfaces de contact

International audienc

Scale-up of polyamide and polyester Parsol® MCX nanocapsules by interfacial polycondensation and solvent diffusion method

The scale-up of oil-containing polyamide nanocapsules produced by simultaneous interfacial polycon-densation and solvent diffusion was successfully achieved. Up to 1500 mL were produced by using a Y-shaped mixer device. The sizes of nanocapsules containing olive oil were modulated from 646 to 211 nm by changing process parameters without modification of the formulation composition. All the results of nanocapsule diameters (d(sc)) expressed as a function of the Reynolds number (Re) showed the existence of a typical power-law relationship. It was demonstrated that the high turbulences created upon nanocapsule formation are the most important parameter allowing to nanocapsule size to be controlled without modifying the formulation composition. Finally, the power-law relationship was used to predict the size of nanocapsules composed of polyamide or polyester and loaded with Parsol (R) MCX. The physico-chemical properties of both polyamide and polyester nanocapsules at the laboratory scale were compared to the ones obtained at the pilot scale. The encapsulation efficiency was higher than 98% in both types of nanocapsules at the laboratory and the pilot scales. The in vitro releases of Parsol (R) MCX from polyester nanocapsules were reproducible at both scales. This is the first time such a power-law was described for the preparation of nanocapsules by interfacial polycondensation and solvent diffusion. (C) 2013 Elsevier B. V. All rights reserved

Scale-up of polyamide and polyester Parsol® MCX nanocapsules by interfacial polycondensation and solvent diffusion method

The scale-up of oil-containing polyamide nanocapsules produced by simultaneous interfacial polycon-densation and solvent diffusion was successfully achieved. Up to 1500 mL were produced by using a Y-shaped mixer device. The sizes of nanocapsules containing olive oil were modulated from 646 to 211 nm by changing process parameters without modification of the formulation composition. All the results of nanocapsule diameters (d(sc)) expressed as a function of the Reynolds number (Re) showed the existence of a typical power-law relationship. It was demonstrated that the high turbulences created upon nanocapsule formation are the most important parameter allowing to nanocapsule size to be controlled without modifying the formulation composition. Finally, the power-law relationship was used to predict the size of nanocapsules composed of polyamide or polyester and loaded with Parsol (R) MCX. The physico-chemical properties of both polyamide and polyester nanocapsules at the laboratory scale were compared to the ones obtained at the pilot scale. The encapsulation efficiency was higher than 98% in both types of nanocapsules at the laboratory and the pilot scales. The in vitro releases of Parsol (R) MCX from polyester nanocapsules were reproducible at both scales. This is the first time such a power-law was described for the preparation of nanocapsules by interfacial polycondensation and solvent diffusion. (C) 2013 Elsevier B. V. All rights reserved

Immunogenicity and immune modulatory effects of in silico predictedL. donovanicandidate peptide vaccines

The purpose of this action research study was twofold: 1) to investigate the role the Socratic Method of teaching had (if any) on the leadership skills of Junior Reserve Officer Training Cadet (JROTC) leaders at a military boarding school in the Midwest, United States, and 2) to determine if there was any change in the researcher’s teaching while implementing the Socratic Method to his JROTC Cadet leaders in his Western Intellectual History class. The researcher defined leadership based on the Five Leadership Practices derived from the Student Leadership Practices Inventory. These practices consisted of Model the Way, Inspire a Shared Vision, Challenge the Process, Enable Others to Act, and Encourage the Heart. Through the collection of data via a pretest and posttest on the leadership skills of the cadet participants, student weekly journal entries, the researcher’s weekly journal entries, classroom observations, an end of the year questionnaire concerning the cadet participants’ self-perceptions of their leadership development, and video-recordings of Socratic discussions, the researcher was able to ascertain the development of leadership skills and his own pedagogical development. The data supported that the cadet participants perceived an improvement in their leadership skills after engaging in the Socratic Method in Western Intellectual History class. Moreover, themes that emerged from the journal entries and answers to the end of the year questionnaire aligned with the leadership characteristics in the Five Leadership Practices. Furthermore, the data revealed that the researcher’s pedagogical experience, specifically in lesson delivery, changed during the time he used the Socratic Method of instruction in his Western Intellectual History class