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

Analysis of genetic diversity and population structure in Argentine and Bolivian Creole cattle using five loci related to milk production

Data from five protein-coding loci related to dairy production were used to study the genetic diversity and population structure of Argentine and Bolivian Creole cattle breeds. Genomic DNA was extracted from blood samples of six Creole cattle breeds: Argentine (n = 230), Patagonian (n = 25); "Saavedreño" (n = 140), "Chaqueño Boliviano" (n = 30), "Yacumeño" (n = 27), and "Chusco" (n = 11). kappa-casein, beta-lactoglobulin, growth hormone and prolactin were measured by PCR-RFLP, while alphaS1-casein was typed by PCR-ASO. The results are discussed, focusing on: historical origin, recent differentiation and selection events, Zebu gene introgression, and population structure. This work shows that: (i) For the studied genes, the observed gene frequency profiles of Argentine and Bolivian Creole cattle breeds were close to the data reported for Iberian breeds and for other South-American Creole cattle breeds which are historically related; (ii) although Zebu gene introgression has been reported at the studied loci, these breeds seem to be far from the Zebu gene frequency profiles; and (iii) the Argentine and Bolivian Creole cattle showed significant levels of subdivision, but each population has maintained its degree of genetic variability

Impacto del nivel socioeconómico en el conocimiento del ictus de la población general: un gradiente de desigualdad social

Resumen: Objetivos: El nivel socioeconómico es un factor que condiciona el comportamiento individual ante la salud y las condiciones de salud de la población. Se evalúa la asociación entre factores socio-demográficos y el conocimiento del ictus en la población general. Método: Estudio transversal. Los sujetos fueron seleccionados por un sistema de asignación al azar doble. Se administró un cuestionario estructurado con preguntas abiertas y cerradas mediante entrevistas cara a cara. El «conocimiento adecuado» fue definido previamente. Se utilizaron el test de Mantel-Haenszel y la regresión logística con modelos ajustados para evaluar la asociación entre el conocimiento del ictus y las variables estudiadas. Resultados: Entrevistas, 2.411; 59,9% mujeres; edad media ± desviación estándar, 49,0 ± 17,3 años. El 74% residente en área urbana. Un 24,7% tenía estudios universitarios, el 15,2% un nivel de escolarización bajo. Solo el 2,1% declaraba ganar mas de 40.000 euros/año y un 29,9% menos de 10.000. Casi el 74% declaró tener un excelente o buen nivel de salud. El desempleo fue del 17,0%. La prevalencia de «conocimiento adecuado» fue del 39,7%(IC del 95%, 37,7%-41,6%). El análisis de tendencias mostró una asociación entre conocimiento y nivel económico (z = 10,14; p < 0,0001); nivel de estudios (z = 15,95; p < 0,0001), estado de salud (z = 7,92; p < 0,0001) y situación laboral (z = 8,98; p < 0,0001). Conclusiones: El nivel de estudios y renta, disponer de trabajo y gozar de salud son factores independientes de un «conocimiento adecuado» del ictus. Las campañas educativas deberían realizarse con un lenguaje sencillo y dirigirse con especial interés a las clases sociales mas desfavorecidas. Abstract: Objectives: Socioeconomic status is a factor that influences health-related behaviour in individuals as well as health conditions in entire populations. The objective of the present study was to analyse the sociodemographic factors that may influence knowledge of stroke. Method: Cross-sectional study. A representative sample was selected by double randomisation. Face-to-face interviews were carried out by previously trained medical students using a structured questionnaire with open- and closed-ended questions. Adequate knowledge was previously defined. The Mantel-Haenszel test and adjusted logistic regression analysis were used to assess the association between knowledge of stroke and the study variables. Results: 2411 subjects were interviewed (59.9% women; mean age 49.0 [SD 17.3] years) Seventy-three per cent were residents of urban areas, 24.7% had a university education, and 15.2% had a low level of schooling. Only 2.1% reported earning more than 40 000 euros/year, with 29.9% earning less than 10 000. Nearly 74% reported having an excellent or good state of health. The unemployment rate was 17.0%. Prevalence of “adequate knowledge” was 39.7% (95% CI: 37.7%-41.6%). Trend analysis showed an association between knowledge of stroke and income (z = 10.14, P < 0.0001); educational level (z = 15.95, P < 0.0001); state of health (z = 7.92, P < 0.0001); and employment status (z = 8.98, P < 0.0001). Conclusions: Educational level, income, employment status, and state of health are independent factors for adequate knowledge of stroke. Public awareness campaigns should present material using simple language and efforts should be directed toward the most disadvantaged social strata in particular. Palabras clave: Ictus, Educación, Factores sociales, Promoción de la salud, Metodología, Conocimiento, Keywords: Stroke, Education, Social factors, Health promotion, Methods, Knowledg

Unlocking Thesis Data phase one

Unlocking Thesis Data (UTD) is a community-driven project to promote the use of persistent identifiers for theses, their underlying data and their authors. By their very nature, PhD theses break new ground and advance scholarly knowledge. Most make use of newly-created data but these data can be trapped in an appendix or DVD – either unavailable or not suited for reuse. UTD will make data more discoverable and citeable, thereby offering incentives to students to share their data in more appropriate formats, in the context of a sustainable national thesis framework. Funded by Jisc, UTD is led by the Universities of East London and Southampton and EThOS (the UK’s national thesis service at the British Library). Phase one will explore current thesis practice through an online survey to EThOS member institutions, and individual case studies looking at the issues in more detail – including how institutions might apply DOI and ORCID identifiers. The survey and case study findings will be combined into a report with recommendations for further phases of the project. These are expected to enhance metadata and software for applying DOI and ORCID identifiers, to test them in live settings, and to offer comprehensive advice for institutions to adopt them. By summer 2016 we expect to have a sustainable infrastructure covering the whole UK, driving the wider availability of research data and introducing doctoral students to new norms of scholarly communication

Galactic transient sources with the Cherenkov Telescope Array

International audienceA wide variety of Galactic sources show transient emission at soft and hard X-ray energies: low-mass and high-mass X-ray binaries containing compact objects (e.g., novae, microquasars, transitional millisecond pulsars, supergiant fast X-ray transients), isolated neutron stars exhibiting extreme variability as magnetars as well as pulsar wind nebulae. Although most of them can show emission up to MeV and/or GeV energies, many have not yet been detected in the TeV domain by Imaging Atmospheric Cherenkov Telescopes. In this paper, we explore the feasibility of detecting new Galactic transients with the Cherenkov Telescope Array (CTA) and the prospects for studying them with Target of Opportunity observations. We show that CTA will likely detect new sources in the TeV regime, such as the massive microquasars in the Cygnus region, low-mass X-ray binaries with low-viewing angle, flaring emission from the Crab pulsar-wind nebula or other novae explosions, among others. We also discuss the multi-wavelength synergies with other instruments and large astronomical facilities

Galactic transient sources with the Cherenkov Telescope Array

International audienceA wide variety of Galactic sources show transient emission at soft and hard X-ray energies: low-mass and high-mass X-ray binaries containing compact objects (e.g., novae, microquasars, transitional millisecond pulsars, supergiant fast X-ray transients), isolated neutron stars exhibiting extreme variability as magnetars as well as pulsar wind nebulae. Although most of them can show emission up to MeV and/or GeV energies, many have not yet been detected in the TeV domain by Imaging Atmospheric Cherenkov Telescopes. In this paper, we explore the feasibility of detecting new Galactic transients with the Cherenkov Telescope Array (CTA) and the prospects for studying them with Target of Opportunity observations. We show that CTA will likely detect new sources in the TeV regime, such as the massive microquasars in the Cygnus region, low-mass X-ray binaries with low-viewing angle, flaring emission from the Crab pulsar-wind nebula or other novae explosions, among others. We also discuss the multi-wavelength synergies with other instruments and large astronomical facilities