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

Sialic Acids - From The Comprehension Of Their Involvement In Biological Processes To Antiinfluenza Drug Design [Ácidos Siálicos - Da Compreensão Do Seu Envolvimento Em Processos Biológicos Ao Desenvolvimento De Fármacos Contra O Agente Etiológico Da Gripe]

Sialic acids are nine-carbon carbohydrates that occur widely in nature and occupy the terminal portions of some glycoproteins and glycolipids of cell membranes. These carbohydrates are closely involved in cell-cell interactions and in processes such as microbial infection, inflammation, etc. Studies on the participation of sialic acids in biological processes have provided comprehension about their role in the infection by the influenza virus, the causal agent of flu. 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Parallels Between Plants And Animals In The Production And Molecular Targets Of Nitric Oxide

Considerable evidence that nitric oxide (NO) and its derivatives play major roles in mammals has led to an interest in the actions of these molecules in plant metabolism. The ubiquitous distribution of nitric oxide synthases (NOS) in mammalian cells has stimulated the search for an equivalent enzyme in plants. NOS-like activity has been found in many plants and NO has been shown to influence various developmental processes and to have a role in plant defense responses against pathogens. Several of the major NO targets characterized in animals also have found similar actions in plants. 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Curcumin Conjugates And Metallocomplexes As Lead Compounds For Development Of Anticancer Agents - A Short Review

The plant kingdom is a rich source of compounds with anticancer activities. Curcumin [1,7-bis(4-hydroxy-3-methoxyphenyl)-1,6-heptadiene-3,5-dione] (1) is a secondary metabolite produced by rhizomes of Curcuma longa that has been used for centuries in traditional Medicine in Asia. Anticancer activity is one of the pharmacological properties of curcumin (1) that has been widely explored. Its targets include transcription factors, growth and angiogenesis regulators, apoptosis-related genes, adhesion-related molecules, and cellular signaling molecules. Some curcumin conjugates and metallocomplexes have been synthesized, characterized and evaluated for anticancer activity. In this mini-review, we discuss the mechanism of action by which curcumin (1) inhibits the progression of tumor growth and also the antiproliferative activity of curcumin conjugates and metallocomplexes on human cancer cells. 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