22 research outputs found
Comparative study of Pap smear abnormalities in HIV infected and HIV non-infected women
- Publication venue
- 'Medip Academy'
- Publication date
- 01/03/2016
- Field of study
Background: HIV positive women are more likely than HIV negative women to have cervical dysplasia. Incidence of HPV-related dysplasia increases as immune function declines. To analyse the prevalence of cervical dysplasia on papsmear among women affected with HIV and to compare with that of HIV negative women.Methods: The study period was of 6 months duration from December 2010 to May 2011. Cervical cytology specimen from HIV positive and HIV negative women who attended the OPD of Institute of Maternal and Child Health, Government Medical College, Kozhikode. Were collected after excluding known case of carcinoma cervix, post hysterectomy patients, patients with bleeding per vagina and also those with active genital tract infections.Results: A prospective study of 200 females (100 HIV positive and 100 HIV negative) was done in our hospital. Age range was between 36 and 50 years. PAP smear abnormality was obtained in 35% of the study group. Out of which 21% was seen in HIV positive patients and 14% in HIV negative patients. Prevalence of LSIL (low grade squamous intraepithelial lesion) was significantly higher among HIV positive patients. Abnormality was not associated with CD4 count, HIV status of husband or addictions of husband, not associated with number of partners of husband both in HIV positive and negative patients.Conclusions: PAP smear abnormality (overall), prevalence of LSIL was significantly higher among HIV positive patients. It was not associated with SES, age of first intercourse, number of partners of wife and other immunosuppressive status
INVESTIGATION OF ADAPTIVE BEAMFORMING ALGORITHMS FOR COGNITIVE RADIO ARCHITECTURE
- Publication venue
- Publication date
- 24/04/2020
- Field of study
ABSTRACT The present fixed spectrum assignment policy becomes a bottleneck for more efficient spectrum utilization, as majority of the already scarce spectrum goes under-utilized. The concept of Cognitive Radio has been receiving increasing attention as a solution to the aforementioned quandary, since it equips the capability to optimally adapt their operating parameters according to the interactions with the surrounding radio environment. In this paper, the feasibility of a smart antenna to this system is analyzed and the performance of the different beamforming algorithms is compared
Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.
- Author
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- Publication venue
- J Clin Oncol
- Publication date
- 01/01/2020
- Field of study
PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks
Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study
- Author
- Aawsaj Y.
- Abad Gurumeta A.
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- Publication venue
- 'American Society of Clinical Oncology (ASCO)'
- Publication date
- 01/01/2021
- Field of study
PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks
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Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial.
- Author
- Abbass Hakam
- Adhikari Neill
- Affleck Julia
- Agno Sathianathan Ronan
- Ahmad Norfaizan
- Ahmed Iram
- Ainscough Kate
- Al Qasim Eman
- Al Swaidan Lolowa
- Al-Bassam Wisam
- Al-Beidh Farah
- Al-Beidh Farah
- Albert Martin
- Alegria Ana
- Alexander Brian
- Alexander Peter
- Allan Angela
- Allan Elizabeth
- Allen Louise
- Allibone Suzanne
- Amaro dos Santos Catorze Teodoro
- Anderson Tom
- Andric Zdravko
- Angus Derek
- Angus Derek C
- Anjum Aisha
- Ankert Juliane
- Annane Djillali
- Annane Djillali
- Anstey Matthew
- Antcliffe David
- Aparicio Christelle
- Appelt Peter
- Arabi Yaseen
- Arabi Yaseen
- Arbane Gill
- Archer Simon
- Aref Noah
- Arias Ana-Marie
- Arishi Hatim
- Arnold Donald
- Asghar Adeeba
- Ashelford Angela
- Attwood Ben
- Austin Karen
- Aysel Florescu Simin
- Azaiz Amine
- Babel Jakša
- Babio-Galan Maite
- Badie Julio
- Bagshaw Sean
- Baillie Kenneth
- Baker Evelyn
- Bakthavatsalam Dhanalakshmi
- Bamford Peter
- Banach Dorota
- Bannard-Smith Jonathan
- Barbazza Leanne
- Barber Russell
- Barge Deborah
- Barnes Nicky
- Baršić Bruno
- Bashyal Archana
- Basile Kim
- Bass Frances
- Bates Michelle
- Bauchmuller Kris
- Bean Sarah
- Beane Abigail
- Beane Abigail
- Beasley Richard
- Begin Phillipe
- Bellemare David
- Benettaib Fatna
- Benzekri Dalila
- Berdaguer Fernando Daniel
- Bergin Colin
- Berry Lindsay
- Berry Lindsay
- Berry Scott
- Berry Scott
- Bhimani Zahra
- Bhimani Zahra
- Bihari Shailesh
- Bihari Shilesh
- Binnie Alexandra
- Bion Julian
- Biradar Vishwanath
- Birch Janine
- Birch Jenny
- Birchall Katie
- Birkinshaw Isobel
- Black Ethel
- Bloos Frank
- Board Jasmin
- Bone Allsion
- Bonner Stephen
- Bonten Marc
- Bonten Marc
- Borgatta Barbara
- Borrill Zoe
- Bosch Ziekenhuis Jeroen
- Boschert Catherine
- Bossard Isabelle
- Boumahni Dounia
- Bourgoin Charlotte
- Bourne Michelle
- Bourne Richard
- Bouwman Wietske
- Bowler Helen
- Boyd Craig
- Bracke Stephanie
- Bradbury Charlotte
- Bradbury Charlotte
- Bradley-Potts Joanne
- Brailsford Jane
- Brain Matthew
- Brant Emily
- Breen Patrick
- Brett Stephen
- Brewer Chris
- Brickell Kathy
- Brightling Chris
- Brillinger Nicole
- Brimfield Lutece
- Brinkerhoff Gail
- Brochard Laurent
- Brohi Farooq
- Browne Troy
- Brunkhorst Frank
- Brunkhorst Frank
- Budd Joanna
- Buehner Ulrike
- Buhr Heidi
- Bullman Laetitia
- Burns Karen
- Burt Karen
- Buscher Hergen
- Butler Amelia
- Butler M
- Buxton Meredith
- Buxton Meredith
- Buzgau Adrian
- Byrne Deborah
- Byrne Kathleen
- Bélteczki János
- Cabreros Leilani
- Calfee Carolyn
- Callender Owen
- Campbell Andy
- Campbell Hilary
- Campbell Lewis
- Camsooksai Julie
- Caplin Cecile
- Carbonneau Elaine
- Carmona Flores Rosario
- Carr-Knott Lisa
- Carrier François Martin
- Carrier Marc
- Cartner Brittney
- Casey Ruth
- Casey Siobhan
- Castro Ferreira Ricardo Manuel
- Cate Heidi
- Cathcart Susanne
- Cavayas Alexandros
- Cawley Kathryn
- Cazzola Federica
- Centofanti John
- Chablani Manish
- Chamara Warnapura Loku
- Chan Carmen
- Chan Charles
- Chan Peter
- Charlewood Richard
- Charron Cyril
- Chartier Delphine
- Chasse Michael
- Chassé Michaël
- Chen Yan
- Cheng Allen
- Cheng Allen C
- Cherian Shiney
- Cheung Winston
- Chhablani Manish
- Chudeau Nicolas
- Cirstea Emanuel
- Clarey Emma
- Claridge Helen
- Clark Michele
- Clark Sarah
- Claxton Andrew
- Clermont Giles
- Cloutier Ève
- Coburn Susan
- Codreanu Daniel
- Coghlan Phoebe
- Cole Jade
- Coles Holly
- Coles Jennifer
- Colin Gwenhael
- Collier Dawn
- Collins Daniel
- Collins Emma
- Collins Joanne
- Connor Jason
- Cooke Jill
- Cooper Jamie
- Cooper Melanie
- Cornell Sarah
- Cort Jon
- Courtin Laura
- Cowdrey Keri-Anne
- Cowley Nicholas
- Cowton Amanda
- Coyne Mark
- Craner Michelle
- Craven Thomas
- Creagh-Brown Ben
- Crisp Nikki
- Croft Maria
- Cusack Rebecca
- Cutler Sean
- Cviljevic Sabina
- Cárcel Fernández Sheila
- Daly James
- Daly Zoe
- Daneman Nick
- Dark Paul
- Darreau Cédric
- Dasgin Joanne
- Davey Miriam
- Davidson Neil
- Davies Gwyneth
- Davies Louisa
- Davies Michelle
- Dawda Ashlish
- Day Christopher
- De Beaux Fiona
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- de Courcy-Golder Kim
- de Jager P
- de Jong Menno
- De Jong Menno
- de Jonge E
- de la Fuente Martos Carmen
- de Lima Pereira Tiago Nuno Alfaro
- de Man Angelique
- De Waele Jan
- Dearden Joy
- Dechert William
- Deelchand Vashish
- Dela Rosa Arnold
- Dell Amanda
- Demetriou Carrie
- Depante Maria Theresa
- Depuydt Pieter
- Dequin PierreFrançois
- Derde Lennie
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- Detry Michelle
- Detry Michelle
- Deye Nicolas
- Digby Stephen
- Distler Michael
- Doble Patricia
- Donnelly Adrian
- Donnison Phil
- Doran Peter
- Dragija Lidija
- Driscoll Alana
- Drummond Andrew
- Duan Erick
- Duffy Eamon
- Duke Graeme
- Duncan Tracey
- Duplaix Mathilde
- Dushianthan Ahilanandan
- Dyas Sarah
- D’Aragon Frédérick
- D’Souza Ramsy
- Effelaar Evelien
- Elhassan Munzir
- Elin Hall Rebecca
- Ellis Christine
- Elmahi Einas
- Elsefi Tarek
- English Shane
- Estcourt Lise
- Estcourt Lise
- Estensen Kristen
- Everitt Robert
- Evers Mirjam
- Farahi Neda
- Fartoukh Muriel
- Faulkner Beverley
- Faulkner Maria
- Fazekas Ágnes
- Felton Tim
- Ferguson Niall
- Ferguson Susan
- Fergusson Dean
- Fernández de Pinedo Artaraz Ziortza
- Ferrier Janet
- Fierens Jan
- Finn André
- Finn Stephanie
- Fischer Roy
- Fitzgerald Mark
- Fitzgerald Mark
- Fletcher Simon
- Flint Neil
- Forbes Andrew
- Forbes Loretta
- Forton Daniel
- Fortune Louise
- Fottrell-Gould Deirdre
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- van Bentum Puijk Wilma
- van Bentum-Puijk Wilma
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- van de Veerdonk Frank
- van de Veerdonk Frank
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- Watpool Irene
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- Webb Steve
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- Wedd Steve
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- Weissman Alexandra
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- Writing Committee for the REMAP-CAP Investigators
- Xavier Kugan
- Xia Le Tai Charlotte
- Yarad Elizabeth
- Yates David
- Young Chelsea
- Young Ian
- Young Meredith
- Young Paul
- Yusuff Hakeem
- Zaharia Miahela Florentina
- Zaidi Abbas
- Zaki Ahmed
- Zaman Mohsin
- Zammit Claire
- Zapalac Marija
- Zarychanski Ryan
- Zarychanski Ryan
- Zhao Xiao Bei
- Zinzoni Vanessa
- Zitter Letizia
- Đimoti Renata
- Publication venue
- JAMA: Journal of the American Medical Association
- Publication date
- 06/10/2020
- Field of study
Importance: Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited. Objective: To determine whether hydrocortisone improves outcome for patients with severe COVID-19. Design, Setting, and Participants: An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin. Between March 9 and June 17, 2020, 614 adult patients with suspected or confirmed COVID-19 were enrolled and randomized within at least 1 domain following admission to an intensive care unit (ICU) for respiratory or cardiovascular organ support at 121 sites in 8 countries. Of these, 403 were randomized to open-label interventions within the corticosteroid domain. The domain was halted after results from another trial were released. Follow-up ended August 12, 2020. Interventions: The corticosteroid domain randomized participants to a fixed 7-day course of intravenous hydrocortisone (50 mg or 100 mg every 6 hours) (n = 143), a shock-dependent course (50 mg every 6 hours when shock was clinically evident) (n = 152), or no hydrocortisone (n = 108). Main Outcomes and Measures: The primary end point was organ support-free days (days alive and free of ICU-based respiratory or cardiovascular support) within 21 days, where patients who died were assigned -1 day. The primary analysis was a bayesian cumulative logistic model that included all patients enrolled with severe COVID-19, adjusting for age, sex, site, region, time, assignment to interventions within other domains, and domain and intervention eligibility. Superiority was defined as the posterior probability of an odds ratio greater than 1 (threshold for trial conclusion of superiority >99%). Results: After excluding 19 participants who withdrew consent, there were 384 patients (mean age, 60 years; 29% female) randomized to the fixed-dose (n = 137), shock-dependent (n = 146), and no (n = 101) hydrocortisone groups; 379 (99%) completed the study and were included in the analysis. The mean age for the 3 groups ranged between 59.5 and 60.4 years; most patients were male (range, 70.6%-71.5%); mean body mass index ranged between 29.7 and 30.9; and patients receiving mechanical ventilation ranged between 50.0% and 63.5%. For the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively, the median organ support-free days were 0 (IQR, -1 to 15), 0 (IQR, -1 to 13), and 0 (-1 to 11) days (composed of 30%, 26%, and 33% mortality rates and 11.5, 9.5, and 6 median organ support-free days among survivors). The median adjusted odds ratio and bayesian probability of superiority were 1.43 (95% credible interval, 0.91-2.27) and 93% for fixed-dose hydrocortisone, respectively, and were 1.22 (95% credible interval, 0.76-1.94) and 80% for shock-dependent hydrocortisone compared with no hydrocortisone. Serious adverse events were reported in 4 (3%), 5 (3%), and 1 (1%) patients in the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively. Conclusions and Relevance: Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support-free days within 21 days. However, the trial was stopped early and no treatment strategy met prespecified criteria for statistical superiority, precluding definitive conclusions. Trial Registration: ClinicalTrials.gov Identifier: NCT02735707
Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries
- Author
- Abad-Motos A.
- Abbas A.M.
- Abbas M.
- Abbasi M.
- Abbott T.
- Abdalaal I.
- Abdel-Galil K.
- Abdelemam R.
- Abdelgawad A.
- Abdelkarim M.
- Abdelkhalek M.
- Abdelmageed A.
- Abdelmawgoud S.
- Abdelmohsen S.
- Abdelrahman A.S.
- Abdelrahman M.
- Abdelwahab K.
- Abdou H.
- Abdulai D.R.
- Abdulkhaleq M.
- Abdullah B.
- Abdulsalam K.
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- Abdur-Rahman L.
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- Thomakos N.
- Thomas B.
- Thomas J.J.
- Thuduvage V.
- Thumbadoo R.
- Tian S.
- Tidjane A.
- Tirloni L.
- Toia F.
- Tokidis E.
- Tokocin M.
- Tolani M.A.
- Toma E.A.
- Tomasicchio G.
- Tomlinson J.
- Tonini V.
- Torre B.
- Torregrosa C.
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- Tousidonis M.
- Trabulsi N.
- Tranca S.
- Trebol J.
- Trejo-Avila M.
- Triantafyllou A.
- Triantafyllou T.
- Trifunovski A.
- Tripathi M.
- Tripathi P.
- Tripathy S.
- Trivik-Barrientos F.
- Trostchansky I.
- Trulson A.
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- Tsakiridis N.
- Tsiantoula P.
- Tsironis D.
- Tsolakidis A.
- Tsoulfas G.
- Tucker O.
- Tuech J.J.
- Turan A.
- Turi S.
- Turna A.
- Turrado-Rodriguez V.
- Turri G.
- Tutino R.
- Tuyishime E.
- Tzelves L.
- Tzima I.
- Tzimas G.
- Ubiali P.
- Ubom A.E.
- Ugwu A.O.
- Ugwu E.
- Ugwu I.
- Ulas A.B.
- Uldry E.
- Ulgur H.S.
- Ulkucu A.
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- Ulman H.
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- Underwood K.
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- Usman M.I.
- V G.M.M.
- Vaassen L.
- Vagena X.
- Vagge A.
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- Valadez T.A.C.
- Valanci S.
- Valdespino C.P.
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- Valladares S.C.
- Vallve-Bernal M.
- Van Acker J.
- Van Den Eynde J.
- Van Goor H.
- Van Vliet H.
- Van Wyk N.N.
- Vanni C.
- Vas A.
- Vasarhelyi E.
- Vaschetti R.
- Vassiliu P.
- Vatansever D.
- Vatish J.
- Vaughan-Shaw P.G.
- Vaysburg D.
- Veglia A.
- Velten M.
- Velázquez M.J.M.
- Venkatappa S.K.
- Venketeswaran M.
- Venskutonis D.
- Verbic M.S.
- Verdi D.
- Vergara-Fernandez O.
- Verhoeff K.
- Veroux M.
- Verras G.-I.
- Verre L.
- Vida L.
- Vidya R.
- Viglietta E.
- Vijay V.
- Vijgen G.
- Vilaró B.C.
- Villanueva J.
- Vilz T.O.
- Vincent E.
- Vinci D.
- Viola S.
- Violante T.
- Vishnoi J.R.
- Vissapragada R.
- Vivancos L.G.
- Vives J.M.M.
- Vizzielli G.
- Vohra L.
- Vokshi I.
- Vosinakis C.
- Vásquez J.A.G.
- Vázquez I.O.
- Vázquez P.J.G.
- Văcărașu A.B.
- Wade R.
- Wafi O.
- Wagner G.
- Wallis C.
- Wanjara S.
- Waqar S.H.
- Warden C.
- Warner C.
- Wason S.
- Wasserman I.
- Watcyn-Jones T.
- Waterson B.
- Watson D.
- Watson M.
- Weber C.
- Wheatstone P.
- Wheeler J.
- Wheldon L.
- White M.
- White S.
- White W.
- Wickramasinghe D.
- Widmer L.W.
- Wiedemann D.
- Wiesinger C.G.
- Wijekoon N.
- Wijenayake W.
- Wijeyaratne M.
- Wijeysundera D.
- Wiles M.
- Wilkin R.
- Wilkins A.
- Wilkins J.
- William T.G.
- Williams O.M.
- Williams S.
- Windsor J.
- Winnand P.
- Wittmann M.
- Wolde A.
- Wolfenden J.W.D.
- Wong B.N.X.
- Wong E.
- Wong E.G.
- Wong G.K.C.
- Wong H.Y.F.
- Wong K.Y.
- Wormald J.
- Wright D.
- Wright J.
- Wu F.
- Wurm M.
- Xenaki S.
- Yadev I.
- Yahaya A.S.
- Yakubu M.
- Yang W.
- Yanık Ö
- Yanowsky-Reyes G.
- Yassin A.
- Yates E.
- Yebes A.
- Yenli E.M.T.-A.
- Yeoh T.
- Yeung J.
- Yiallourou A.
- Yigit B.
- Yildirim A.
- Yim G.
- Yiu A.
- Yonekura H.
- Yotsov T.
- Younis M.U.
- Yunus A.
- Yusefi H.
- Zabaleta J.
- Zabkiewicz C.
- Zaccaria G.
- Zacharia B.
- Zafar S.N.
- Zago M.
- Zaheen Z.
- Zahid Z.
- Zaimis T.
- Zakaria A.D.
- Zambon M.
- Zamora L.
- Zampogna B.
- Zancana G.
- Zani A.
- Zanin L.
- Zanini N.
- Zapardiel I.
- Zapata C.S.
- Zarif P.
- Zaránd A.
- Zehnder P.
- Zenger S.
- Zenha H.
- Zhu M.Z.L.
- Ziemann S.
- Zimak D.M.
- Zimak Z.
- Zivkovic D.
- Zizzo M.
- Zucker B.
- Zwain Y.
- Zyskowski M.
- Ávila C.C.
- Älgå A.
- Çakıcı MÇ
- Çelik E.
- Çelik M.N.
- Özçay N.
- Şevi̇k H.
- Šantak G.
- Šimko K.
- Žatecký J.
- Publication venue
- Oxford University Press (OUP)
- Publication date
- 01/07/2023
- Field of study
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
Para-infectious brain injury in COVID-19 persists at follow-up despite attenuated cytokine and autoantibody responses
- Author
- Adeniji Kayode
- Aggleton John P.
- Agranoff Daniel
- Agwuh Ken
- Ahmed Katie A.
- Ail Dhiraj
- Al-Chalabi Ammar
- Aldera Erin L.
- Alegria Ana
- Alex Beatrice
- Allen Christopher M.
- Allen Sam
- Amin Jay
- Andrikopoulos Petros
- Angus Brian
- Armour Cherie
- Armstrong Jane A.
- Ashish Abdul
- Ashworth Milton
- Asiimwe Innocent G.
- Atkinson Dougal
- Bach Benjamin
- Baillie J. Kenneth
- Baillie J. Kenneth
- Baker Mark R.
- Bakshi Siddharth
- Barclay Wendy S.
- Bari Shahedal
- Barlow Gavin
- Barlow Samantha L.
- Barnass Stella
- Barrett Nicholas
- Barrett Suzanne
- Bassford Christopher
- Basu Neil
- Basude Sneha
- Batra Rahul
- Baxter David
- Beadsworth Michael
- Benjamin Laura
- Bernatoniene Jolanta
- Berridge John
- Berry Colin
- Best Nicola
- Bethlehem Richard
- Blackledge Bethan
- Boardman Sarah A.
- Bogaert Debby
- Booth Laura
- Bothma Pieter
- Bradley John R.
- Bradley John R.
- Breen David P.
- Breen Gerome
- Breen Gerome
- Brennan Benjamin
- Breuer Judith
- Brittain-Long Robin
- Broome Matthew R.
- Bullmore Edward
- Bullock Katie
- Bulteel Naomi
- Burden Tom
- Burtenshaw Andrew
- Butler Matthew
- Carlucci Nicola
- Carracedo Alejandra D.
- Carson Alan
- Carson Gail
- Caruth Vikki
- Cass Emily
- Catterall Benjamin W.
- Cavanagh Jonathan
- Cavanagh Jonathan
- Chadwick David
- Chambler Duncan
- Chand Meera
- Chechi Kanta
- Chee Nigel
- Child Jenny
- Chinnery Patrick F.
- Chiollaz Anne-Cecile
- Christmas David
- Christmas David M.
- Chukkambotla Srikanth
- Clark Jordan J.
- Clark Jordan J.
- Clark Richard
- Clark Tom
- Clarke Emily A.
- Clohisey Sara
- Cole Sarah
- Coleman Jonathan R.
- Coles Alaisdair
- Coles Alasdair J.
- Collie Ceryce
- Collie Ceryce
- Collini Paul
- Connor Marie
- Cooke Graham S.
- Cooper Louise
- Cosgrove Catherine
- Cossette Nadine
- Cousins David
- Coutts Audrey
- Cox Helen
- Cupitt Jason
- Cutino-Moguel Maria-Teresa
- da Silva Ana
- Dalton Jo
- Darby Alastair
- Dark Paul
- David Anthony S.
- Davies Nicholas
- Davis Christopher
- Dawson Chris
- de Silva Thushan
- Defres Sylviane
- Dervisevic Samir
- Digby Richard
- Dincarslan Oslem
- Docherty Annemarie B.
- Dodd Katherine C.
- Donegan Cara
- Donnelly Lorna
- Donnison Phil
- Donohue Chloe
- dos Santos Gonçalo
- Douthwaite Sam
- Drake Thomas M.
- Dregan Alex
- Drummond Andrew
- Duff Eugene
- Dumas Marc-Emmanuel
- Dunai Cordelia
- Dunai Cordelia
- Dunn Chris
- Dunning Jake
- DuRand Ingrid
- Dushianthan Ahilanadan
- Dyer Philip
- Dyer Tristan
- Easton Ava
- Ebrahimi Soraya
- Egbe Franklyn N.
- Elliott Angela
- Ellul Mark A.
- Evangelou Nikos
- Evans Anthony
- Evans Cariad
- Eziefula Chi
- Facer Bethany
- Fairfield Cameron J.
- Fawkes Angie
- Fegan Chrisopher
- Fernandes Peter M.
- Finch Lorna
- Finn Adam
- Fisher Lewis W.
- Flaherty Lisa
- Fletcher Tom
- Foster Terry
- Fower Andrew
- Fox Hannah
- Francis Richard
- Fullerton Duncan
- Gamble Carrol
- Garcia-Dorival Isabel
- Garg Atul
- Garg Sanjeev
- Garjani Afagh
- George Lily
- Gilchrist Tammy
- Girvan Michelle
- Gkrania-Klotsas Effrossyni
- Glen Kiran
- Godden Jo
- Goldsmith Arthur
- Graham Clive
- Grammatikopoulos Tassos
- Green Christoper A.
- Greenhalf William
- Gregory Rebecca
- Griffin Julian L.
- Griffiths Fiona
- Griffiths Michael
- Griffiths Michael
- Grimbly Victoria
- Grundmann Alexander
- Grundmann Alexander
- Gunatilake Savini
- Gunning Philip
- Gupta Rishi K.
- Hafezi Katarzyna
- Halpin Sophie
- Hamid Shahd H.
- Hampshire Adam
- Hannah C.
- Hardwick Hayley
- Hardwick Marc
- Hardy Elaine
- Harris Jade D.
- Harrison Ewan
- Harrison Ewen M.
- Harrison Janet
- Harrison Neil
- Harrison Neil A.
- Harrison Paul J.
- Hartley Catherine
- Hartmann Monika
- Hartshorn Stuart
- Harvey Daniel
- Havalda Peter
- Hawcutt Daniel B.
- Held Marie
- Hendry Ross
- Hetherington Claire
- Hiscox Julian
- Hobrok Maria
- Hodel Eva M.
- Hodgson Luke
- Holden Karl
- Holland Angela E.
- Holmes Anthony
- Horby Peter W.
- Hormis Anil
- Hotopf Matthew
- Howard Joanne
- Huang Yun
- Hughes Stella
- Husain Masud
- Ijaz Samreen
- Irani Sarosh
- Irani Sarosh R.
- Jackson Clare
- Jackson Thomas
- Jacobs Michael
- Jain Susan
- Jenkins Thomas M.
- Jennings Paul
- Jensen Rebecca L.
- Jezzard Peter
- Jones Christopher B.
- Jones Trevor R.
- Kaliappan Agilan
- Kasipandian Vidya
- Keating Seán
- Kegg Stephen
- Keller Simon
- Kelsey Michael
- Kendall Jason
- Kerrison Caroline
- Kerslake Ian
- Khandaker Shadia
- Khoo Saye
- King Katharine
- Kingston Nathalie
- Kiy Robyn T.
- Klenerman Paul
- Knight Stephen R.
- Knight Susan
- Koch Oliver
- Koduri Gouri
- Koshy George
- Koukorava Chrysa
- Kyaw Sandar
- Laha Shondipon
- Lahnsteiner Eva
- Laird Steven
- Lake Annette
- Lant Suzannah
- Larkin Susan
- Latawiec Diane
- Lavelle-Langham Lara
- Law Andrew
- Lee James
- Leek Charles
- Leeming Gary
- Lefteri Daniella
- Leibowitz Maya
- Leiner Tamas
- Lett Lauren
- Lewis Gabriella
- Lewis Matthew R.
- Liggi Sonia
- Lilleker James B.
- Lillie Patrick
- Lim Wei S.
- Limb James
- Linnett Vanessa
- Little Jeff
- Livoti Lucia A.
- Lunn Michael P.
- Lyttle Mark
- MacGillivray Louise
- MacIver Claire L.
- Maclean Alan
- MacMahon Michael
- MacNaughton Emily
- Madarshahian Daniel
- Mancini Maria
- Mankregod Ravish
- Mansoori Parisa
- Marsh Laura
- Martin Naomi
- Maslen Lynn
- Massey Hannah
- Masson Huw
- Matovu Elijah
- Maziere Nicole
- McCafferty Sarah
- McCullough Katherine
- McDonald Sarah
- McDonald Sarah E.
- McDonnell Gavin
- McEvoy Laurence
- McEwen Ruth
- McGlinchey Emily
- McIlwaine Ryan
- McIntosh Andrew M.
- McLauchlan John
- Mclean Kenneth A.
- Meda Manjula
- Menon David K.
- Menon David K.
- Mentzer Alexander J.
- Merson Laura
- Metelmann Soeren
- Meynert Alison M.
- Miah Nahida S.
- Michael Benedict D.
- Michael Benedict D.
- Middleton Joanna
- Miller Karla
- Mills Gary
- Minton Jane
- Mitchell Joyce
- Mohandas Kavya
- Mok Quen
- Monssen Dina
- Moon James
- Moore Elinoor
- Moore Shona C.
- Morgan Patrick
- Morrice Kirstie
- Morris Christopher M.
- Morris Craig
- Mortimore Katherine
- Moses Samuel
- Mpenge Mbiye
- Mulholland Ciaran
- Mulla Rohinton
- Murphy Derek
- Murphy Ellen G.
- Murphy Lee
- Murphy Michael
- Nagarajan Thapas
- Nagel Megan
- Nair Akshay
- Needham Edward
- Needham Edward J.
- Nelson Mark
- Newcombe Virginia
- Nicholas Nathalie
- Nicholson Timothy
- Norman Lisa
- Norris Lillian
- Norris Lucy
- Norton Emma
- Noursadeghi Mahdad
- O'Malley Ronan
- O'Shea Matthew K.
- Olanipekun Michael
- Oosthuyzen Wilna
- Openshaw Peter J.
- Openshaw Peter J.
- Osagie Anthonia
- Ostermann Marlies
- Otahal Igor
- Paddick Stella-Maria
- Pais Mark
- Palmarini Massimo
- Palmieri Carlo
- Palmos Alish
- Palmos Alish
- Panchatsharam Selva
- Papakonstantinou Danai
- Papineni Padmasayee
- Paraiso Hassan
- Patel Arvind
- Patel Brij
- Pattison Natalie
- Paxton William A.
- Peacock Sharon
- Pendered Sophie
- Penrice-Randal Rebekah
- Pepperell Justin
- Peters Mark
- Phull Mandeep
- Pilgrim Jack
- Pintus Stefania
- Pius Riinu
- Planche Tim
- Plotkin Daniel
- Pollak Thomas
- Pollakis Georgios
- Pooni Jagtur S.
- Post Frank
- Price David
- Price Nicholas
- Prince Tessa
- Prout Rachel
- Rae Nikolas
- Rambaut Andrew
- Ren Alexander
- Reschreiter Henrik
- Reynolds Tim
- Reynolds Will
- Richardson Neil
- Ridley P. M.
- Roberts Angela
- Roberts Devender
- Roberts Mark
- Roberts Stephanie
- Robertson David L.
- Rogers Henry C.
- Rose Alistair
- Rota Silvia
- Rousseau Guy
- Ruge Bobby
- Russell Clark D.
- Ryan Brendan
- Sales Debby
- Salman Rustam A.
- Saluja Taranprit
- Samuel Merna
- Sanchez Jean-Charles
- Sancho-Shimizu Vanessa
- Sands Caroline J.
- Sargent Brendan
- Saviciute Egle
- Sawcer Stephen J.
- Schmid Matthias L.
- Scott Janet T.
- Scott-Brown James
- Seed Adam W.
- Semple Malcolm G.
- Semple Malcolm G.
- Semple Scott
- Shah Aarti
- Shankar-Hari Manu
- Shanmuga Prad
- Sharma Anil
- Sharma Parul
- Shaw Catherine A.
- Shaw Pamela J.
- Shaw Victoria
- Shaw Victoria E.
- Shawcross Anna
- Shears Rebecca K.
- Sieradzki Adam
- Sigfrid Louise
- Singh Bhagteshwar
- Sizer Jeremy
- Small Benjamin
- Smith Craig J.
- Smith Jacqueline
- Smith Richard
- Smith Stephen
- Snelson Catherine
- Solomon Tom
- Solomon Tom
- Spencer Rebecca G.
- Spittle Nick
- Sriskandan Shiranee
- Staines Nikki
- Stambach Tom
- Stewart James P.
- Stewart Richard
- Stirrups Kathy
- Stuart David
- Subramaniam Krishanthi
- Subramaniam Krishanthi S.
- Subudhi Pradeep
- Summers Charlotte
- Sunderland Geraint
- Swann Olivia V.
- Szakmany Tamas
- Szemiel Agnieska
- Taams Leonie
- Taams Leonie S.
- Taggart Aislynn
- Tait Sarah
- Takats Zoltan
- Takis Panteleimon
- Tamborska Arina
- Tanianis-Hughes Jolanta
- Tatham Kate
- Tato Esteban
- Taylor John-Paul
- Tedder Richard S.
- Tharmaratnam Kukatharmini
- Thomas Jo
- Thomas Jordan
- Thomas Rhys H.
- Thompson A. A. R.
- Thompson Chris
- Thompson Robert
- Thomson Emma
- Thomson Emma C.
- Thwaites Ryan S.
- Tonder Libby v.
- Tridente Ascanio
- Trochu Erwan
- Tupper-Carey Darell
- Turtle Lance C.
- Twagira Mary
- Underwood Jonathan
- Upthegrove Rachel
- Vallotton Nick
- van Daniel J.
- Vancheeswaran Rama
- Veenith Tonny
- Venneri Annalena
- Vincent Angela
- Vincent Angela
- Vincent Rachel
- Vincent-Smith Lisa
- Visuvanathan Shico
- Vuylsteke Alan
- Waddy Sam
- Wai Antonia Y.
- Wake Rachel
- Walden Andrew
- Welters Ingeborg
- Wham Murray
- Whitehouse Tony
- Whittaker Paul
- Whittington Ashley
- Wijesinghe Meme
- Wilcock Eve
- Williams Guy B.
- Williams Martin
- Williams Robyn
- Williams Steven
- Wilson Lawrence
- Winchester Stephen
- Wiselka Martin
- Wolverson Adam
- Wong Sui H.
- Wood Greta K.
- Wood Greta K.
- Wood Nicholas
- Wootton Daniel G.
- Workman Andrew
- Wrobel Nicola
- Yates Bryan
- Young Peter
- Zambon Maria
- Zandi Michael S.
- Zelaya Fernando
- Zhang J. E.
- Publication venue
- Nature Research
- Publication date
- 22/12/2023
- Field of study
To understand neurological complications of COVID-19 better both acutely and for recovery, we measured markers of brain injury, inflammatory mediators, and autoantibodies in 203 hospitalised participants; 111 with acute sera (1–11 days post-admission) and 92 convalescent sera (56 with COVID-19-associated neurological diagnoses). Here we show that compared to 60 uninfected controls, tTau, GFAP, NfL, and UCH-L1 are increased with COVID-19 infection at acute timepoints and NfL and GFAP are significantly higher in participants with neurological complications. Inflammatory mediators (IL-6, IL-12p40, HGF, M-CSF, CCL2, and IL-1RA) are associated with both altered consciousness and markers of brain injury. Autoantibodies are more common in COVID-19 than controls and some (including against MYL7, UCH-L1, and GRIN3B) are more frequent with altered consciousness. Additionally, convalescent participants with neurological complications show elevated GFAP and NfL, unrelated to attenuated systemic inflammatory mediators and to autoantibody responses. Overall, neurological complications of COVID-19 are associated with evidence of neuroglial injury in both acute and late disease and these correlate with dysregulated innate and adaptive immune responses acutely
Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19
- Author
- ?ivko Iris
- Abbass Hakam
- Abdeladim Lilia
- Abdelhady Hesham
- Abdelkharim Hussam
- Abdelrazik Marwa
- Abdi Zakee
- Abdukahil Sheryl Ann
- Abel Lynn
- Abraham Jacinta
- Abrahamson Gail
- Abusamra Yousuf
- Aceto Romina
- Adams Nick
- Adams Peter
- Adebambo Olumide
- Adhikari Neill
- Adhikari Sheetal
- Affleck Julia
- Agha Gloria
- Aghemo Alessio
- Agno Ronan
- Ahmad Norfaizan
- Ain Quratul
- Ainscough Kate
- Ainsworth James
- Aitken Lindianne
- Akamp Ceren
- Al Enezi Farhan
- Al-Bassam Wisam
- Al-Beidh Farah
- Albert Martin
- Albrett Jonathan
- Alderman Meera
- Aldo Bonizzoni Matteo
- Alegria Ana
- Alessandro Carà Gianmarco
- Alexander Brian
- Alexander Peter
- Alfonso Jordan
- Ali Maryam
- Ali Murtaza
- Allam Hayat
- Allen Barbara
- Allen Louise
- Allibone Suzanne
- Almeshhedani Hasham
- AlQahtani Samah
- Alswaidan Lolowa
- Altomy Mohammed
- Al Amri Ali
- Al Qasim Eman
- Amatya Sameena
- Ambrosino Richard
- Anderson Thomas
- Andreae Mark
- Aneman Anders
- Angus Derek C.
- Anjum Aisha
- Ankert Juliane
- Annane Djillali
- Anne-Laure Fedou
- Anstey Matthew
- Antcliffe David
- Anthony Alpha
- Antoine Marchalot
- Antoine Pierre
- Antoine Studer
- Anumakonda Vikram
- Aparicio Christelle
- Aquino Maia
- Arabi Yaseen M.
- Arachchige Malka
- Aravindan Latha
- Arbane Gill
- Archambault Patrick
- Archer Simon
- Aref Noah
- Arias Ana-Marie
- Arias Sonia
- Arishi Hatim
- Arnold Donald
- Arnold John
- Arnott Andrew
- Arora Anand
- Aryal Diptesh
- Asghar Adeeba
- Asif Namra
- Aspinwall Angelique
- Attokaran Antony
- Attwood Ben
- Au Carly
- Audry Mathilde
- Austin Karen
- Austin Pauline
- Auvet Adrien
- Avard Bronwyn
- Awan Sidra
- Ayee Robert
- Azaiz Amine
- Azzaui Harun
- Babu Suresh
- Bacon Gina
- Badalamenti Salvatore
- Badie Julio
- Bagavathy Kavitha
- Bagot Catherine
- Bagshaw Sean
- Baig Nadia
- Baikady Ravishankar
- Bailey Lucy
- Baillie Kenneth
- Bain William
- Baker Alice
- Baker Evelyn
- Baker Stuart
- Bakthavatsalam Dhanalakshmi
- Balaie Morteza
- Balls-Burgess Sam
- Bamford Amy
- Bamford Peter
- Banach Dorota
- Bannard-Smith Jonathan
- Barbash Ian
- Barber Russell
- Barbier François
- Barge Deborah
- Bariola Ryan
- Barker Gareth
- Barker Stephanie
- Barnes Nicky
- Baron Rebecca M.
- Barreau Amelie
- Barreau Amélie
- Bart Robert
- Bartholomew Jazz
- Bartley Shauna
- Barton David
- Barton Frances
- Bashyal Archana
- Basile Kim
- Bass Frances
- Bassford Christopher
- Bastos Joana Margarida Pereira Sousa
- Bates Michelle
- Bates Samantha
- Batista Teresa Margarida Oliveira
- Bauchmuller Kris
- Bayne Madeleine
- Bean Sarah
- Beane Abi
- Beane Abigail
- Beard Gregory
- Beasley Richard
- Beaudoin Rosalie
- Beavis Sarah
- Beddows Seonaid
- Bedford Caroline
- Beer Deborah
- Beer Sally
- Begin Phillipe
- Begum Salma
- Bell Gillian
- Bellemare David
- Belletti Allesandro
- Bendjemar Lynda
- Benettaib Fatna
- Bensen Nicole
- Bentley Andrew
- Benyon Sarah
- Benzekri Dalila
- Beqai Besa
- Berdaguer Fernando
- Beresford Stephanie
- Bergin Colin
- Berry Lindsay R.
- Berry Scott
- Berryman Emily
- Bertel Melanie
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- Woodward Robert
- Woolett Melissa
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- Wright Kim
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- Wyatt Rachel
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- Xavier Kugan
- Yamagishi Yoshiaki
- Yamashita Chizuru
- Yang Yang
- Yarad Elizabeth
- Yates Bryan
- Yates David
- Yealy Donald
- Young Ian
- Young Meredith
- Young Paul
- Youngstein Taryn
- Yu Haili
- Yusuff Hakeem
- Zaharia Mihaela
- Zaidi Abbas
- Zaki Ahmed
- Zaman Mohsin
- Zarychanski Ryan
- Zdanavidiene Ausra
- Zhao Xiao
- Zinzoni Vanessa
- Zitter Letizia
- Zouita Louisa
- Publication venue
- 'American Medical Association (AMA)'
- Publication date
- 11/04/2023
- Field of study
IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19.
Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19.
DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022).
INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days.
MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes.
RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively).
CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes.
TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570
Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries
- Author
- Abad-Motos Ane
- Abbas Ahmed M.
- Abbas Mostafa
- Abbasi Mujeeb
- Abbott Tom
- Abd Karim Muhammad Fairuz Shah
- Abdalaal Ibrahim
- Abdel-Galil Khalid
- Abdelemam Rania
- Abdelgawad Abdalrahman
- Abdelkarim Maryam
- Abdelkhalek Mohamed
- Abdelmageed Abdelfatah
- Abdelmawgoud Sherif
- Abdelmohsen Sarah
- Abdelrahman Ahmed Saber
- Abdelrahman Mostafa
- Abdelwahab Khaled
- Abdou Hossam
- Abdulai Darling Ramatu
- Abdulkhaleq Marwa
- Abdullah Bahiyah
- Abdulsalam Khalifa
- Abdulsalam Shuaib
- Abdur-Rahman Lukman
- Abdus-Salam Rukiyat
- Abdussalam Hameedat Opeyemi
- Abebrese John Tabiri
- Abeldaño Ariel
- Abou-Khalil Jad
- Abou-Taleb Hisham
- Abozid Anwaar
- Abozied Hesham
- Abrate Alberto
- Abu-Zaid Ahmed
- Abubakar Mohammed Kabir
- Abud Burçin
- Abuzaid Mohammed
- Adam Albushra Altayeb
- Adamina Michel
- Adamou Harissou
- Adamu Auwal
- Adamu Kabir Musa
- Adanu Kekeli
- Adebara Idowu
- Adebola Oluwaseyi
- Ademuyiwa Adesoji
- Adeniran Abiodun
- Adepiti Akinfolarin
- Aderogba Adeleke Akeem
- Adesunkanmi Abdulhafiz
- Adeyeye Ademola
- Adisa Adewale
- Adjeso Theophilus Justus Kofi
- Ads Adel Mohamed
- Ads Alaa Mohamed
- Adu-Aryee Nii Armah
- Adumah Collins
- Afzal Irrum
- Agapov Mikhail
- Agarwal Gaurav
- Agarwal Ravi
- Agbeko Anita Eseenam
- Agbeno Evans Kofi
- Agbonrofo Peter
- Agboola Oluseyi
- Aggarwal Gaurav
- Aghadi Ifeanyi
- Aghtarafi Natasha
- Agrawal Amit
- Agresta Ferdinando
- Aguado Héctor J.
- Aguilera-Arevalo Maria-Lorena
- Aherne Thomas
- Ahmad Aline
- Ahmad Maleeha
- Ahmad Misbahu
- Ahmad Sarwat
- Ahmad Shahzaib
- Ahmad Shoaib
- Ahmed Hayat Tarig Abdelhafiz
- Ahmed Khalid
- Ahmed Sharwany
- Ahmed Shima
- Ahmed Usama
- Aisuodionoe-Shadrach Oseremen
- Aitken Sarah
- Ajenifuja Kayode
- Ajiya Abdulrazak
- Akeel Nouf
- Akin Emrah
- Akinajo Opeyemi
- Akinyemi Tosin
- Akrida Ioanna
- Aktokmakyan Talar Vartanoglu
- Akwaisah Ayoub
- Al Bettar Osama
- Al-Badawi Ismail A.
- Al-Juaifari Maytham
- Al-Khyatt Waleed
- Al-Mallah Abdullah
- Al-Nusairi Ahmed
- Al-Saadi Nina
- Al-Sayaghi Khaled
- Al-Shaiji Tariq
- Al-Shehari Mohammed
- Al-Touny Aiman
- Al-Touny Shimaa A.
- Aladawi Omar
- Aladna Abdallah
- Alali Mahmoud
- Alam Mahmood
- Alam Mohammed Shadrul
- Alarabi Rehab
- Alawneh Yazan
- Alayande Barnabas
- Albanese Erminia
- Albayadi Eslam
- Albdour Maram
- Alconchel Felipe
- Alderazi Amer
- Alegbeleye Bamidele
- Alekberli Tural
- Alemu Misganaw Alemu Adimass
- Alexander Philip
- Alfieri Alex
- Algahtany Khaled
- Algarni Kamal
- Alhamad Ameen
- Alhamid Mohammad
- Alharmi Rawan A. Rahman
- Alharthi Mohammed
- Alhazmi Barrag
- Ali Mohamed Shafi Mahboob
- Ali Stephen
- Alibrahim Hidar
- Aljaaly Hattan
- Aljaiuossi Anas
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- Piozzi Guglielmo Niccolò
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- Sodhai Vivek
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- Sokolov Manol
- Solaini Leonardo
- Sole Oriol Martin
- Sole-Sedeno Josep M.
- Soljic Martina
- Solli Piergiorgio
- Soon Wai Cheong
- Sorbi Flavia
- Sotiropoulou Maria
- Sotudeh Mohadeseh
- Souadka Amine
- Soucheiron Maria Coronas
- Soytas Mustafa
- Sozzi Giulio
- Sparavigna Marco
- Spartalis Michael
- Spellar Kayleigh
- Spiers Harry V. M.
- Spina Alfio
- Spriano Giuseppe
- Squiers John
- Stabler Robert
- Stamatakis Emmanouil
- Stamatis Konstantinos
- Starr Nichole
- Stather Philip
- Stevens Sean
- Stevenson Andrew
- Stewart Grant D.
- Stijns Jasper
- Stogowski Piotr Tomasz
- Stoleriu Mircea Gabriel
- Stoyanov Vladislav
- Street John
- Strotmann Johanna Josefine
- Stroumpoulis Konstantinos
- Su Yu-Xiong
- Suarez Sara Busto
- Subramani Yamini
- Subramaniam Sentilnathan
- Sue-Chue-Lam Colin
- Suer Muhammed Salih
- Sulaiman Bilal
- Sultania Mahesh
- Sundarraju Shalini
- Sungurtekin Hulya
- Suresh Sreelakshmi
- Surya Ilham Utama
- Swed Sarya
- Syllaios Athanasios
- Symeonidis Dimitrios
- Szabómihályová Katarína
- Szakmany Tamas
- Szatmary Peter
- Sztipits Tamás
- Szyluk Karol
- Sá-Marta Eduarda
- Sánchez Alberto Cabañero
- Sánchez Rosa
- Sánchez-Guillén Luis
- Süleyman Marlen
- Tadic Boris
- Taha Anas
- Taha-Mehlitz Stephanie
- Tailor Bhavesh
- Taj Eldeen Samaher Taj Eldeen Hassan
- Takeda Flavio Roberto
- Takkenberg Marijn
- Talat Nabila
- Tallon-Aguilar Luis
- Talwar Rishi
- Tamayo Beatriz Villota
- Tamburello Sara
- Tamini Nicolò
- Tammo Ömer
- Tamoos Khalil
- Tampaki Ekaterini Christina
- Tampakis Athanasios
- Tan Chih Ying
- Tan Shawn Jia Hwang
- Tanal Mert
- Tanas Yousef
- Tang Alethea
- Tang Yita
- Tani Sobhana Iftekhar
- Tantraworasin Apichat
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- Tapia-Herrero Ana-María
- Tarek Ahmed
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- Tashkandi Wail
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- Tatsis Dimitris
- Tawalbeh Ra'Fat
- Tawiah Augustine
- Tebha Sameer
- Techapongsatorn Suphakarn
- Teixeira Pedro
- Tejero-Pintor Francisco J.
- Tellez Karla Susana Martin
- Tellez Luis Garcia-Sancho
- Thaha Mohamed Adhnan
- Thakar Sumit
- Thaw May Htoo
- Theivendran Kanthan
- Thekkinkattil Dinesh
- Theochari Nikoletta
- Theodoropoulos George
- Theophilidou Elena
- Thereska Dariel
- Thiruchandran Gajendiran
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- Thomas Bradley
- Thomas Jerin Jose
- Thuduvage Vasanthika
- Thumbadoo Ruben
- Tian Sarah
- Tidjane Anisse
- Tirloni Luca
- Toia Francesca
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- Toma Elena Adelina
- Tomasicchio Giovanni
- Tomlinson James
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- Tottman R.
- Tousidonis Manuel
- Trabulsi Nora
- Tranca Sebastian
- Trebol Jacobo
- Trejo-Avila Mario
- Triantafyllou Alexandra
- Triantafyllou Tania
- Trifunovski Aleksandar
- Tripathi Manjul
- Tripathi Prashant
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- Trostchansky Ivan
- Trulson Alexander
- Trungu Sokol
- Truss Adam
- Tsakiridis Ioannis
- Tsakiridis Nikolaos
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- Tsolakidis Alexandros
- Tsoulfas Georgios
- Tucker Olga
- Tuech Jean Jacques
- Turan Alparslan
- Turi Stefano
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- Turri Giulia
- Tutino Roberta
- Tuyishime Eugene
- Tzelves Lazaros
- Tzima Ioanna
- Tzimas George
- Ubiali Paolo
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- Valeanu Liana
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- Valladares Sergio Chávez
- Vallve-Bernal Marc
- Van Acker Jill
- Van Den Eynde Jef
- Van Goor Harry
- Van Vliet Helen
- Van Wyk Naomi Natasha
- Vanni Camilla
- Vas Aurelia
- Vasarhelyi Edward
- Vaschetti Roberto
- Vassiliu Panteleimon
- Vatansever Dogan
- Vatish Jamie
- Vaughan-Shaw Peter G.
- Vaysburg Dennis
- Veglia Antonella
- Velten Markus
- Velázquez Maria Jose Martinez
- Venkatappa Sunil Kumar
- Venketeswaran Meenakshi
- Venskutonis Donatas
- Verbic Milena Senica
- Verdi Daunia
- Vergara-Fernandez Omar
- Verhoeff Kevin
- Veroux Massimiliano
- Verras Georgios-Ioannis
- Verre Luigi
- Vida Lucian
- Vidya Raghavan
- Viglietta Edoardo
- Vijay Vardhini
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- Vilaró Blanca Capdevila
- Villanueva Julio
- Vilz Tim O.
- Vincent Elizabeth
- Vinci Danilo
- Viola Simona
- Violante Tommaso
- Vishnoi Jeewan Ram
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- Vives Josep Maria Muñoz
- Vizzielli Giuseppe
- Vohra Lubna
- Vokshi Ismail
- Vosinakis Christos
- Vásquez Javier Alberto Gutiérrez
- Vázquez Gil
- Vázquez Irene Ortega
- Vǎcǎraşu Andrei Bogdan
- Wade Ryckie
- Wafi Omar
- Wagner Gabriela
- Wallis Christopher
- Wanjara Samuel
- Waqar Shahzad Hussain
- Warden Claire
- Warner Christian
- Wasim D.
- Wason Shaun
- Wasserman Isaac
- Watcyn-Jones Tom
- Waterson Ben
- Watson David
- Watson Matthew
- Weber Clemens
- Wheatstone P.
- Wheeler James
- Wheldon Luke
- White Michelle
- White Stuart
- White William
- Wickramasinghe Dakshitha
- Widmer Lukas Werner
- Wiedemann Dominik
- Wiesinger Clemens Georg
- Wijekoon Naveen
- Wijenayake Wasantha
- Wijeyaratne Manuk
- Wijeysundera Duminda
- Wiles Matthew
- Wilkin Richard
- Wilkins Alex
- Wilkins James
- William Tinka George
- Williams Omolara Modupe
- Williams Shekinah
- Windsor John
- Winnand Philipp
- Wittmann Maria
- Wolde Amanuel
- Wolfenden John W. D.
- Wong Benjamin Ngie Xiong
- Wong Enoch
- Wong Evan G.
- Wong George Kwok Chu
- Wong Ho Ying Flora
- Wong Kai Yuen
- Wormald Justin
- Wright Deborah
- Wright Joshua
- Wu Fiona
- Wurm Markus
- Xenaki Sofia
- Yadev Ip
- Yahaya Ahmad Shuib
- Yakubu Mustapha
- Yang Wah
- Yanik Özge
- Yanowsky-Reyes Guillermo
- Yassin Abubaker
- Yates Elizabeth
- Yebes Alvaro
- Yenli Edwin Mwintiereh Ta-Ang
- Yeoh Tien
- Yeung Justin
- Yiallourou Anneza
- Yigit Banu
- Yildirim Asif
- Yim Guang
- Yiu Andrew
- Yonekura Hiroshi
- Yotsov Tsanko
- Younis Muhammad Umar
- Yunus Alif
- Yusefi Hossein
- Zabaleta Jon
- Zabkiewicz Catheriner
- Zaccaria Giulia
- Zacharia Bincy
- Zafar Syed Nabeel
- Zago Mauro
- Zaheen Zakia
- Zahid Zahra
- Zaimis Tilemachos
- Zakaria Andee Dzulkarnaen
- Zambon Martina
- Zamora Lindsey
- Zampogna Biagio
- Zancana Giuseppa
- Zani Augusto
- Zanin Luca
- Zanini Nicola
- Zapardiel Ignacio
- Zapata Carlos Shiraishi
- Zarif Pierre
- Zaránd Attila
- Zehnder Philipp
- Zenger Serkan
- Zenha Horácio
- Zhu Michael Z. L.
- Ziemann Sebastian
- Zimak Danijela Mrazovac
- Zimak Zoran
- Zivkovic Dragana
- Zizzo Maurizio
- Zucker Benjamin
- Zwain Yasir
- Zyskowski Michael
- Ávila Clara Castro
- Älgå Andreas
- Çakici Mehmet Çaǧlar
- Çelik Enes
- Çelik Meryem Nur
- Özçay Necdet
- Şevik Hüsnü
- Šantak Goran
- Šimko Kristián
- Žatecký Jan
- Publication venue
- 'Oxford University Press (OUP)'
- Publication date
- 01/01/2023
- Field of study
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
An automated microfluidic sample preparation system for laser scanning cytometry
- Author
- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- Field of study