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

Anti-allergic effects of lactic acid bacteria and their mechanisms

博士論文 (Doctoral dissertation

Epidemiology and Pathogenesis of Providencia alcalifaciens Infections

Providencia alcalifaciens is a member of the family Enterobacteriaceae that has been commonly implicated as a causative agent of diarrheal infection in humans and animals. Recent outbreaks of P. alcalifaciens in both developing and developed countries have raised public health concerns. Several studies have suggested that P. alcalifaciens can cause diarrhea by invading the intestinal mucosa, although its pathogenicity has not been well established. Often routine laboratory investigations that seek etiological agents of diarrhea do not actively pursue P. alcalifaciens detection. Therefore, routine laboratory diagnosis should be given more attention for better understanding the epidemiology and pathogenicity of P. alcalifaciens

Synthesis and Antimicrobial Activity of Nitrobenzyl-oxy-phenol Derivatives

Two hydroquinone derivatives were prepared and their antimicrobial activity evaluated. Their minimum inhibitory concentrations (MICs) were determined using a broth dilution method. Gentamycin and ciprofloxacin were used as reference antibiotics. The antimicrobial activity of 4-(benzyloxy)phenol (monobenzone) was also evaluated based on its structural similarity to the new compounds; activity was comparable to that of 3,5-dimethyl-4-((4-nitrobenzyl)oxy)phenol (4a). 2,3,5-Trimethyl-4-((4-nitrobenzyl)oxy)phenol (4b) exhibited the best antibacterial activity against both clinical isolates and type strain of Moraxella catarrhalis (M. catarrhalis), with a MIC value of 11 μM, comparable to ciprofloxacin 9 μM

Case Report: Bacillus pumilus?Caused Bacteremia in a Patient with Food Poisoning

Bacillus pumilus has rarely been reported as a cause of human infections.We report a case of a B. pumilus causing food poisoning in an adult male.A 51-year-old Japanese man complained of severe abdominal cramps, fever with chills, diarrhea, dizziness, and loss of appetite after eating reheated rice with stewed minced meat purchased from a Kenyan restaurant. Bacillus pumilus was isolated from blood culture and was identified using a biochemical test and 16S rRNA gene sequencing analysis. The patient was treated with probiotics and ciprofloxacin and recovered after 3 days. To our knowledge, this is the first report describing the potential role of B.pumilus as a foodborne pathogen in Kenya and highlights the importance of good hygiene and food preparation practices

A priority based energy harvesting scheme for charging embedded sensor nodes in wireless body area networks.

This research work proposes a novel priority aware schedule based charging algorithm that uses wireless power transfer (WPT) technique in order to charge embedded sensor nodes (SNs) in a wireless body area network (WBAN). Implanted sensor nodes in WBANs require energy for both information extraction and data transmission to the remote controller unit. Thus, energy shortage of these SNs deteriorates due to the data transmission process of the patient health monitoring system. However, continuous operation by means of electromagnetic induction for energy harvesting, obtained from ambient sources, reduces the overall efficiency of the primary unit. With this paradigm in sight, an algorithm demonstrating the modeling of a priority-based mechanism is proposed in order to ensure proper sensor voltage level and to reduce the transmission losses. Medium access control (MAC) protocols are used for inductive powering from the primary unit to the secondary unit in a collision-free centralized scheduling scheme. Therefore, the proposed wireless charging algorithm for implanted SNs in WBAN is designed as per carrier sense multiple access with collision avoidance (CSMA/CA) technique. Because of this, the overall power consumption of SNs for certain operation periods, successful charging probabilities for multiple SNs, and instantaneous power requirements are considered as key performance measures of analysis. It is assumed that proper energy storage in both transmitters and receivers can handle channel interference and traffic contention. Simulation results verify that a significant reduction in power consumption for the proposed priority aware algorithm will maintain almost similar output. For this reason, saturating class-C as well as class-E driver circuits have been used to justify the performance in two different circuit topologies. Effects of priority with respect to the full charge period have also been observed for the multi-node system. Furthermore, from performance analysis, it has been demonstrated that the scheduling scheme causes both single MOSFET composed saturating class-C and Lchoke modeled class-E associated driver circuits to be considerably more loss efficient than corresponding existing ones