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

Las políticas de Ciencia, Tecnología e Innovación para la competitividad y la superación de la pobreza en el departamento de Sucre.

La relación entre la Ciencia, la Tecnología y la Innovación - CTI y la competitividad de las regiones y los países es el mundo contemporáneo un hecho trascendental, en este sentido, es necesario que los distintos gobiernos alrededor del mundo, en sus diferentes niveles impulsen políticas públicas en favor de la CTI, contribuyendo de esta forma al desarrollo social, y a la superación de la pobreza en los distintos territorios. El trabajo que se presenta a continuación tiene como objetivo analizar la relación entre los indicadores de CTI, los niveles de competitividad y de pobreza en el departamento de Sucre, haciendo énfasis en los sectores estratégicos de turismo y la rama agropecuaria; para esto, se plantea un estudio de carácter reflexivo, con base en datos y cifras oficiales sobre las variables de interés. Como resultado general, se tiene que, Sucre es un departamento que tiene niveles bajos en materia de CTI, lo que puede incidir en sus bajos niveles de competitividad a nivel nacional, y la prevalencia del fenómeno de la pobreza

Prácticas investigativas de jóvenes investigadores en Sucre, Colombia Vol. 2

Los invitamos a sumergirse en un fascinante viaje a través del esfuerzo y la dedicación de veinte jóvenes investigadores del Departamento de Sucre. Este libro trasciende la mera recopilación de sus experiencias, es un testimonio de su inquebrantable compromiso con el conocimiento y su incansable búsqueda de respuestas en un mundo lleno de incertidumbre y desafíos. A lo largo de un año de intenso entrenamiento, como parte del proyecto “Desarrollo de capacidades y habilidades de investigación, desarrollo tecnológico e innovación en jóvenes profesionales del Departamento de Sucre”, a través de becas-pasantías de investigación, veinte jóvenes valientes del departamento fueron guiados de la mano experta de investigadores destacados. Estos maestros los acompañaron para convertir su pasión por la ciencia en un vehículo de cambio y progreso para nuestra comunidad. Cada capítulo de esta obra refleja las reflexiones, inquietudes, expectativas, miedos y vivencias de estos talentosos investigadores, quienes han asumido el timón de su destino y se han convertido en voces influyentes en la construcción de un futuro más prometedor. Su contribución es fundamental para abordar la falta de desarrollo de capacidades y habilidades en Ciencia, Tecnología e Innovación (CTeI) en jóvenes profesionales de la región.1. La sostenibilidad ambiental y los desafíos en educación en el siglo XXI: una revisión sistemática de la literatura Environmental Sustainability and the Challenges in Education in the 21st Century: a Systematic Review of the Literature Héctor Hernández Navarro, Jorge Luis Barboza Hernández, Mario Gándara Molino, Nubia Hernández Flórez 2. Salud mental en niños y adolescentes víctimas del conflicto armado: una revisión de literatura. Mental Health in Children and Adolescents Victims of the Armed Conflict: a literature Review Jonathan Jesús Aníbal Sierra, Liliana Margarita Meza Cueto , Daymar Junior Navarro Villamizar 3. Gestión del conocimiento como herramienta para la competitividad turística: una revisión de literatura Knowledge Management as a Tool for Tourism Competitiveness: a Literature Review Sol Maira Carrasco Canoles, Emily Andrea Lugo Hernández 4. Herramientas digitales empleadas para la educación del razonamiento clínico en estudiantes de fisioterapia: revisión de literatura Digital Tools Used for the Education of Clinical Reasoning in Physiotherapy Students: a Review of the Literature Elizabeth Abad Suárez, Meryene Cecilia Barrios Barreto 5. Segunda revolución cuántica y el desarrollo de nuevas tecnologías Second Quantum Revolution and the Development of New Technologies María Camila Vásquez Monterroza, Orlando José García Mojica, Dairo Alfredo Causil Zúñiga 6. Valorización de residuos orgánicos para producir biofertilizantes: revisión bibliométrica de tendencias y avances Valorization of Organic Waste to Produce Biofertilizers: Bibliometric Review of Trends and Advances Nathaly A. Torres Gallo, Daniel D. Otero Meza, Jairo Salcedo Mendoza, Jorge E. Hernández Ruydíaz 7. La diversidad de la familia Araneidae (arachnida: araneae) enColombia: una actualización del listado de especies The Diversity of the Family Araneidae (arachnida: araneae) in Colombia: an Update of the List of Species Yeison López Miranda, José Tovar Márquez, Deivys Moisés Álvarez García 8. Perspectivas agroindustriales de las variedades de yuca cultivadas en el departamento de Sucre: una revisión Agroindustrial Perspectives of Yucca Varieties Cultivated in the Department Sucre: a Review Yoseth David Blanquiceth Támara, Juan José Hoyos Sebá, José David Arias Teherán, María José Tavera Quiroz 9. Uso de tecnologías interactivas en la práctica fonoaudiológica parael lenguaje infantil Use of Interactive Technologies in Speech-Language Practice for Children’s Language Sandra Milena Paternina Pacheco, Marivel Montes Rotela 10. Utilización de residuos agroindustriales en la elaboración de materiales Use of Agroindustrial Waste in the Manufacture of Materials Dayana Paola Morales Escobar, Álvaro Ángel Arrieta Almario1r

Host factors are associated with vaginal microbiome structure in pregnancy in the ECHO Cohort Consortium

Using pooled vaginal microbiota data from pregnancy cohorts (N = 683 participants) in the Environmental influences on Child Health Outcomes (ECHO) Program, we analyzed 16S rRNA gene amplicon sequences to identify clinical and demographic host factors that associate with vaginal microbiota structure in pregnancy both within and across diverse cohorts. Using PERMANOVA models, we assessed factors associated with vaginal community structure in pregnancy, examined whether host factors were conserved across populations, and tested the independent and combined effects of host factors on vaginal community state types (CSTs) using multinomial logistic regression models. Demographic and social factors explained a larger amount of variation in the vaginal microbiome in pregnancy than clinical factors. After adjustment, lower education, rather than self-identified race, remained a robust predictor of L. iners dominant (CST III) and diverse (CST IV) (OR = 8.44, 95% CI = 4.06–17.6 and OR = 4.18, 95% CI = 1.88–9.26, respectively). In random forest models, we identified specific taxonomic features of host factors, particularly urogenital pathogens associated with pregnancy complications (Aerococcus christensenii and Gardnerella spp.) among other facultative anaerobes and key markers of community instability (L. iners). Sociodemographic factors were robustly associated with vaginal microbiota structure in pregnancy and should be considered as sources of variation in human microbiome studies

Effects of pre-operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study an international prospective cohort study

We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care. We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care