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

Anales de Edafología y Agrobiología Tomo 41 Número 9-10

Suelos. Características petroquímicas y micromorfológicas de Haploxeralfs, por P. Arévalo. J. Gallardo y J. Benayas.-- Determinación de manganeso total en suelos, por J. Moreno Caselles, M. Guillén y M. Romero.-- Rendolles de la Sierra de María (Almería), por L J. Alias y J. Martínez.-- Estudio de tres perfiles de suelos de La Alpujarra, por Barahona. E., García Chicano. J. L. Guardiola. J. L. lriarte. A, Pérez-Pujalte, A. y Quirantes, J.-- Detección de concordancias fisonómico-edáficas por J. M. Gómez. R. Rodríguez González. A. García Miranda y C. de Hoyos Alonso.-- Suelos y sedimentos de zonas semiáridas, por A. García Rodríguez, J. Forteza Bonnin y L F. Lorenzo Martín.-- Suelos sobre jumillita de la Sierra de las Cabras (Albacete), por Joaquín Hernández Bastida, María Teresa Fernández Tapia y Francisco Alcaraz Ariza.-- Estudio microscópico de aridisoles de las Islas Canarias, por A. Rodríguez Rodríguez, M. C. Pérez Angles. M. C. Díez de la Lastra Bosch y E. Fernández Caldas.-- El material original: propiedades de los suelos de Galicia, por F. Macias. R. M. Calvo, C. García. E. García-Rodeja y B. Silva.-- Las sierras de Queixa e invernadeiro y sus estribaciones, por Grupo de Edafólogos de Santiago.-- Suelos forestales de la cordillera costero-catalana, por A. Escuredo. V. R. Vallejo y J. Bech.-- Materia orgánica de suelos forestales, por A. Escuredo. V. Vallejo y J. Bech.--Dificultades en el empleo del sistema "USDA-Soil Taxonomy", por Carlos Roquero de Laburu.-- Nematodos fitoparásitos de la superfamilia "criconematoidea", por A. Bello y Ma. Paz Lara.—Silicatos. Retención del diazinon por montmorillonita, sepiolita y caolinita, por G. Dios Cancela, S. González García y M. Martín Aguilar.—Geoquímica. Alteración de minerales de estaño, por Guijarro, J. Casas, J. y Hoyos, M.A.—Nutrición y Fisiología Vegetal.-- Capacidad fotosintética de maíz, por U. Velázquez, M. Lasaña y J. Cardus.-- El alerce en Chile. II. Su nutrición mineral, por M. Lachica, C. González O. y M. Baez. C. Anomalías por deficiencias de Ca o de Mg en raíces de plantas de zea mays L., por José Manuel Pozuelo Guanche.-- Competencia de avena sterilis L .. por R. González Ponce.-- Abcisión de las hojas de phaseolus vulgaris, por Ana María Vieitez y María Luisa Vieitez. El castaño y su resistencia a phytophthora cinnamomi y Ph. cambivora, por Ernesto Vieitez, María Luisa Vieitez y Ana María Vieitez.-- Observaciones sobre el injerto juvenil.del castaño, por María Luisa Vieitez y Ana María Vieitez.-- Crecimiento y nutrición del trébol violeta, por J. Arines y R. Fábregas.-- La proliferación celular en meristemos. por G. Giménez-Manín, J. F. López-Sáez, A. González-Fernández. C. de la Torre y M. H. Navarrete.—Microbiología.-- Formaciones quiméricas anómalas en cultivos bacterianos, por Román de Vicente. Análisis.-- Determinación de fenoles y formas de N en aguas, por Bolarin, M. C. Romero, M. y Caro, M.-- Agua Reutilización de aguas y lodos residuales. I., por Sa/got, M. y Cardus, J. II por Felipo M. T., Garau, M. A., Pascual, M. D. y Cardus, J.-- Ecología. Aspectos ecológicos de sotos y riberas, por Pedro Montserrat Recoder.-- Control Sanitario.Evolución de clorobencilato en brotes de limonero, por J. Ma. Abrisqueta, A. Onuño, J. Gómez y A. Hernansáez.-- Riesgos de los productos químicos potencialmente tóxicos, por Eugenio Laborda. Eduardo de la Peña y Elina Valcarece.-- Geografía. Otra crítica del neomalthusianismo, por María Isabel Bodega Fernández, Sici/ia Gutiérrez Ronco, María Asunción Martín Lou, Antonio Higueras Arnal y José Manuel Casas Torres.-- Notas.-- BibligrafíaPeer reviewe

Erratum to: Guidelines for the use and interpretation of assays for monitoring autophagy (3rd edition) (Autophagy, 12, 1, 1-222, 10.1080/15548627.2015.1100356

non present

Delayed colorectal cancer care during covid-19 pandemic (decor-19). Global perspective from an international survey

Background The widespread nature of coronavirus disease 2019 (COVID-19) has been unprecedented. We sought to analyze its global impact with a survey on colorectal cancer (CRC) care during the pandemic. Methods The impact of COVID-19 on preoperative assessment, elective surgery, and postoperative management of CRC patients was explored by a 35-item survey, which was distributed worldwide to members of surgical societies with an interest in CRC care. Respondents were divided into two comparator groups: 1) ‘delay’ group: CRC care affected by the pandemic; 2) ‘no delay’ group: unaltered CRC practice. Results A total of 1,051 respondents from 84 countries completed the survey. No substantial differences in demographics were found between the ‘delay’ (745, 70.9%) and ‘no delay’ (306, 29.1%) groups. Suspension of multidisciplinary team meetings, staff members quarantined or relocated to COVID-19 units, units fully dedicated to COVID-19 care, personal protective equipment not readily available were factors significantly associated to delays in endoscopy, radiology, surgery, histopathology and prolonged chemoradiation therapy-to-surgery intervals. In the ‘delay’ group, 48.9% of respondents reported a change in the initial surgical plan and 26.3% reported a shift from elective to urgent operations. Recovery of CRC care was associated with the status of the outbreak. Practicing in COVID-free units, no change in operative slots and staff members not relocated to COVID-19 units were statistically associated with unaltered CRC care in the ‘no delay’ group, while the geographical distribution was not. Conclusions Global changes in diagnostic and therapeutic CRC practices were evident. Changes were associated with differences in health-care delivery systems, hospital’s preparedness, resources availability, and local COVID-19 prevalence rather than geographical factors. Strategic planning is required to optimize CRC care