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

Transition metal nanoparticles doped carbon paper as a cost-effective anode in a microbial fuel cell powered by pure and mixed biocatalyst cultures

The poor wettability and high cost of the carbonaceous electrodes materials prohibited the practical applications of microbial fuel cells (MFCs) on large scale. Here, a novel nanoparticles of metal sheathed with metal oxide is electrodeposited on carbon paper (CP) to introduce as high-performance anodes of microbial fuel cell (MFC). This thin layer of metal/metal oxide significantly enhance the microbial adhesion, the wettability of the anode surface and decrease the electron transfer resistance. The investigation of the modified CP anodes in an air-cathode MFCs fed by various biocatalyst cultures shows a significant improving in the MFC performance. Where, the generated power and current density was 140% and 210% higher as compared to the pristine CP. Mixed culture of exoelectrogenic microorganism in wastewater exhibited good performance and generated higher power and current density compared to yeast as pure culture. The excellent capacitance with a distinctive nanostructure morphology of the modified-CP open an avenues for practical applications of MFCs.This work was supported by the National Research Foundation of Korea (NRF) via a grant funded by the government of Korea ( MSIP ) (Grant No. 2015R1C1A1A01054039 ) and in part by Open Laboratory Operational Business Developing and Diffusing the Regional Specialization Technology funded by the Busan Institute of S&T Evaluation and Planning (BISTEP) . Appendix AScopu

A review on the diagnosis infection in cattle of Schistosoma bovis: current status and future prospects Revisão sobre diagnóstico de infecção por Schistosoma bovis em bovinos: estado atual e perspectivas para o futuro

Bovine schistosomiasis, caused by Schistosoma bovis, is a serious veterinary problem in many parts of the worid. The current methods used for the diagnosis of the disease include clinical signs, pathological lesions, parasitological and serological techniques. As clinical signs and parasitological lesions caused by S. bovis are indistinguishable from those induced by other trematode parasites, confirmation of diagnosis by these methods is unreliable. Parasitological techniques used to demonstrate eggs of the parasite in fecal or tissue samples represent the most accurate method for detection of an active S. bovis infection. The tissue of choice for detection of S. bovis infection is the liver because of the visible macroscopic lesion that can be seen in that organ and the rapid detection of the parasite eggs under the microscope using crush smears. The serological techniques used for diagnosis of the disease do not necessarily identify an active infection. In addition, some of the positive reactions are non specific. However, serology is useful to identify previous infection in epidemiologic study. The ELISA has been recentiy validated for the diagnosis of bovine schistosomiasis and will probably replace the other serological tests. The immunoblotting technique has been proven satisfactory to detect antibodies to defined and recombinant schistosome antigen vaccines. Nucleic acid hybridization techniques have been described for the study of schistosome species-specific identification. However, these molecular techniques have not yet revolutionarized diagnosis of schistosomiasis. These techniques will probably serve as the basis for future diagnostic tests.<br>Esquistossomose bovina, causada pelo parasita Schistosoma bovis, é um problema muito sério para a Veterinária em muitas partes do mundo. Os métodos atuais utilizados para o diagnóstico da doença incluem sinais clínicos, lesões patológicas, e técnicas de parasitologia e sorologia. Como os sinais clínicos e as lesões parasitológicas causadas pelo S. bovis são distingüíveis em relação às lesões induzidas por outros trematódeos, a confirmação do diagnóstico por estes métodos é questionável. Técnicas de parasitologia utilizadas para demonstrar ovos do parasita em amostras fecais ou teciduais representam os métodos mais acurados para detecção de uma infecção ativa pelo S. bovis. O tecido de preferência para detecção da infecção causada pelo S. bovis é o fígado devido à visível lesão macroscópica que pode ser vista neste órgão e da rápida detecção dos ovos do parasita usando "crush smears" e visualização microscópica. As técnicas de sorologia utilizadas para o diagnóstico desta doença não identificam necessariamente uma infecção ativa. Adicionalmente, algumas reações positivas não são específicas. Entretanto, sorologia é válida para identificar infecções prévias em um estudo epidemiológico. O teste de ELISA tem sido desenvolvido recentemente para o diagnóstico de equistossomose bovina e provavelmente substituirá os outros testes sorológicos. A técnica de "immunoblotting" tem sido satisfatoriamente aprovada para a detecção de anticorpos e vacinas recombinantes do antígeno do esquistossoma. Técnicas de hibridização do ácido nucleico tem sido descritas para o estudo de identificação de especificidade do schistossoma. Entretanto, estas técnicas moleculares ainda não revolucionaram o diagnóstico da esquistossomose. Provavelmente, estas técnicas ainda serão base para os testes de diagnóstico do futuro