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

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

INDUSTRIAL CROPS AND PRODUCTS

Alternative raw materials for designing novel products are gaining interest in the scientific area. The aim of this study is to investigate the antioxidant and enzyme inhibitory activities of the extracts obtained from Papaver somniferum L. stalks as well as the determination of chemical composition. Antioxidant capacity was tested by using different chemical methods including radical scavenging, reductive effect, phosphomolybdenum and metal chelating assays. Enzyme inhibitory effect was investigated against cholinesterase, tyrosinase, alpha-amylase and alpha-glucosidase. To detect chemical composition, phenolic profile was determined by high performance liquid chromatography (HPLC) as well as total contents of the phytochemicals. The aqueous extract was found to contain high amount of phenolics and flavonoids [9.87 mu mol gallic acid equivalents (GAEs)/g dry plant (dp) and 0.09 mu mol rutin equivalents (REs)/g dp, respectively]. The methanol and aqueous extracts were also found to contain considerable amounts of (-)-epicatechin and syringic acid. Antioxidant activity tests were resulted in the superiority of the methanol extract. The extracts did not show inhibitory activity on cholinesterases and tyrosinase. Inhibitory activity of the aqueous extract on alpha-amylase and alpha-glucosidase were found to be 9.85 and 78.64 mu mol acarbose equivalents (ACEs)/g dp, respectively. As a result, P. somniferum stalks, one of the major by-products of poppy cultivation, can be used as the alternative source of antioxidant and enzyme inhibitory compounds in food and medical industries

Can the stalks of Papaver somniferum L. be an alternative source of bioactive components?

Alternative raw materials for designing novel products are gaining interest in the scientific area. The aim of this study is to investigate the antioxidant and enzyme inhibitory activities of the extracts obtained from Papaver somniferum L. stalks as well as the determination of chemical composition. Antioxidant capacity was tested by using different chemical methods including radical scavenging, reductive effect, phosphomolybdenum and metal chelating assays. Enzyme inhibitory effect was investigated against cholinesterase, tyrosinase, α-amylase and α-glucosidase. To detect chemical composition, phenolic profile was determined by high performance liquid chromatography (HPLC) as well as total contents of the phytochemicals. The aqueous extract was found to contain high amount of phenolics and flavonoids [9.87 μmol gallic acid equivalents (GAEs)/g dry plant (dp) and 0.09 μmol rutin equivalents (REs)/g dp, respectively]. The methanol and aqueous extracts were also found to contain considerable amounts of (−)-epicatechin and syringic acid. Antioxidant activity tests were resulted in the superiority of the methanol extract. The extracts did not show inhibitory activity on cholinesterases and tyrosinase. Inhibitory activity of the aqueous extract on α-amylase and α-glucosidase were found to be 9.85 and 78.64 μmol acarbose equivalents (ACEs)/g dp, respectively. As a result, P. somniferum stalks, one of the major by-products of poppy cultivation, can be used as the alternative source of antioxidant and enzyme inhibitory compounds in food and medical industries. © 2018 Elsevier B.V

Onosma heterophyllum: Phenolic composition, enzyme inhibitory and antioxidant activities

Onosma species have frequently been used for their colouring and dyeing properties in foods and medicinal preparations. The antioxidant and enzyme inhibitory activities of the ethyl acetate, methanol and water extracts of Onosma heterophyllum (Griseb.) are described. Phytochemical compositions of these extracts were also determined. The water extract showed not only remarkable antioxidant activity in all assays but also considerable inhibitory activity on tyrosinase and α-glucosidase (112.44 μmol KAEs/g dry plant and 984.36 μmol ACEs/g dry plant, respectively). The methanol extract exhibited the highest inhibitory activity on acetylcholinesterase (AChE) and α-amylase (79.18 μmol GALAEs/g dry plant and 10.42 μmol ACEs/g dry plant, respectively). Chromatographic analyses revealed that the water extract was found to be rich in phenolic and flavonoid contents. On the basis of the correlation coefficients calculated separately for all experimental parameter pairs, protocatechuic acid, p-hydroxybenzoic acid, syringic acid, p-coumaric acid and luteolin were found to be highly in correlation with the antioxidant and enzyme inhibitory activities. This study demonstrates that O. heterophyllum, contained in food preparations with various purposes for many years, could be used for the treatment of diabetes as well as its skin whitening effect. © 2017 Elsevier B.V

Comparative evaluation of dietary supplementation with mannan oligosaccharide and oregano essential oil in forced molted and fully fed laying hens between 82 and 106 weeks of age

The aim of this study was to investigate the efficacy of feed-grade preparations of mannan oligosaccharides (MOS) and oregano essential oil (OEO) in forced molted or fully fed 82-week-old, laying hens. A 2 x 3 factorial experiment investigated the influence of molting vs. full feeding and dietary supplements [i.e., unsupplemented control, MOS (1 g/kg) diet, and OEO (24 mg/kg) diet] on production parameters, egg quality, serum stress indicators, blood constituents, tibial characteristics, liver antioxidant status, and cecal microflora composition. A total of 864 Single Comb White Leghorn hens were randomly assigned to 6 treatments, each with 6 replicates of 24 hens each, and studied for 25 wk. Hens were fed a molt diet containing of 50% alfalfa and 50% wheat bran (aa+wb) for 12 d, then returned to the laying ration. Results indicate that molt vs. full feed impacted more on most variables measured than supplementation or supplement type. Significant (P < 0.01) interactions between molting and diet were observed for the egg production, egg weight, egg mass, and feed conversion ratio (FCR). In fully fed hens, MOS supplementation improved (P < 0.01) the egg production, egg weight, and FCR, and an OEO addition significantly improved the egg production and FCR in forced molted hens. Molting improved egg quality despite the significant regression in ovary and oviduct weight (P < 0.01), though supplements showed no influence. The bone ash (P < 0.01) and mineral content (P < 0.05) of molted hens were significantly lower than those of fully fed counterparts; however, poor mineralization was not reflected in the bones' mechanical properties. No significant differences were observed among treatments for hematological characteristics. Both the MOS and particularly the OEO supplementation improved (P < 0.01) liver antioxidant status and mitigated the significant increase in cecal pathogenic bacteria after molt. Our results indicate that full feeding with an aa+wb diet is an effective non-feed-removal method for molted hens, the benefit of which can be improved with MOS and OEO supplementation