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

Preparation of zeolite microspheres and their application in biology

Hollow zeolite microspheres were prepared by growing a thin zeolite membrane shell on seeded polystyrene beads. The removal of the organic growth directing agent and polystyrene bead was successfully performed without damaging the thin zeolite shell. The storage and delivery of sodium pervanadate, a potent tyrophosphatase inhibitor to MDCK cells was successfully carried out. Thus, demonstrating the potential use of these materials for biological studies of cell signaling

Zeolite micropattern on biological application

Zeolite micropattern created from structurally similar hydrophobic Sil-1 and hydrophilic ZSM-5 zeolites, and tested for the immobilization of fluorescein isothiocyanate conjugate bovine serum albumin (BSA-FITC), biotin conjugate bovine serum albumin (Biotin-BSA), Hochest 33342 and rhodamine conjugate α- bungatoxin, were preferentially deposited onto hydrophobic ZSM-5 patterns regardless of the pattern geometry. Being inorganic, the zeolite micropattern does not deteriorate with time and can be readily reused by simply burning away the deposited chemicals and biomolecules. This suggests that compositional micropattern of zeolite could be used to create high resolution array of biomolecules on flat substrate