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

HATILDAĞ (GÖYNÜK/BOLU) SAHASI BİTÜMLÜ KAYAÇLARINDAKİ ELEMENT ZENGİNLEŞMELERİ

Bu çalışmada Bolu ili Göynük ilçesi Hatıldağ sahasında yer alan Kabalar formasyonu bitümlü kayaçlarındaki (bitümlü şeyl, bitümlü kiltaşı ve bitümlü marn) element zenginleşmelerinin belirlenmesi ve ekonomik açıdan maden yatağı olabilirliği araştırılmıştır. Element Analizleri ICP-ES (ICP emission spectrometry) ve ICP-MS (ICP mass spectrometry) teknikleri ile yapılmıştır. Kayaçlardaki organik karbon miktarları ise Rock-Eval VI cihazı ile analiz edilmiştir. Formasyondan ölçülen Kayalık Dere ÖSK’sından alınan 28 adet bitümlü kayaç- da yapılan piroliz analizlerinde Corg minumum 0.40 %wt, maksimum 8.25 %wt olup, Corg ortalaması 3,6 %wt’dır. Tespit edilen ana ve iz elementler dünya çapında anoksik koşullarda depolandığı bilinen Peru Kıyısal Şelfi Sedimanları, Namibya Kıyısal Şelfi Sedimanları, Kaliforniya Körfezi Sedimanları, Akdeniz Sapropelleri, Karadeniz Sapropelleri, Senomaniyen/ Turoniyen (C/T) Demerara Yükselimi Anoksik Sedimanları ve C/T Gubbio Anoksik Sedimanlarına ait ana ve iz element değerleri ile kıyaslanmıştır. İncelenen örneklerde ana ve iz element konsantrasyonlarının ortalama şeyle göre zenginleşmeleri belirlenmiştir. Kayalık Dere ÖSK’sında ana elementlerden Fe, Mg, Ca ve K, iz elementlerden ise As, Ba, Co, Cu, Ni, Rb, Sr, V, Zn ve Zr’nun kıyaslanan havzalara göre daha fazla zenginleştiği görülmüştür. Örneklerimizdeki Ca, Mg ve Ba gibi elemetlerin diğer ortamlardan yüksek çıkması depolanma ortamımızın daha karbonatlı ve suboksik olduğunu göstermektedir

Emotional Control and Parental Involvement’s Effects on Students at Mandiri Vocational School’s Psychological Well-Being

This study aims to reveal the effect of parental involvement and emotional regulation on students' psychological well-being. The research method used is correlational research which aims to determine the effect between variables. The research population was 410 Mandiri SMK students. Samples were taken randomly as much as 25% of the total population, namely 103 people. The research instrument was a questionnaire about psychological well being, parental involvement, and emotion regulation which was designed with a Likert Scale. Data were analyzed using multiple regression techniques. Based on the analysis, the following research results were obtained: (1) there was a significant effect of parental involvement on students' psychological well-being. This is indicated by the tx1y value of 2.586 > 1.657 with p <0.05; (2) There is a significant effect of emotion regulation on students' psychological well being. This is indicated by the tx2y value of 2.165 > 1.657 with p <0.05; (3) There is a significant effect of parental involvement and emotional regulation on students' psychological well-being. This is indicated by the tx1tx2y value of 8.059 > 1.657 with p <0.05. Thus, parental involvement and emotional regulation have an impact on the psychological well-being of Mandiri SMK students

Discourse Analysis of the Meaning of Love in the Novel Love Never Gets Old Using Genette's Narrative Theory

This study aimed to analyze the discourse on the meaning of love that arose from the mood in the twelve stories “Love Never Gets Old” by Benny Arnas in 2014. The mood of the story was analyzed based on various points of view of the characters that influenced the discourse in the story. Genette's Narrative Theory regarding mood was the main key to uncovering the most prominent discourse so that the meaning of the text could be carried out in an orderly manner. The mood was useful in the meaning of the text to determine the position of the narrator in each story character. The results of this study indicated that the most prominent meaning after determining the storyteller, the scene, and the form of speech was about the distance between the narrator and the reader of the work, which influenced the discourse on the meaning of love. The most dominant view in this collection of stories was “I", which correlated with the character Samin. Based on the dominant point of view, love has four types, namely love for fellow human beings, love for property and God, and a form of love for oneself. The results of the data analysis revealed that the meaning of love that emerged was Samin's love for himself

SNG100, a novel topical treatment for moderate atopic dermatitis, in patients aged 6 years or older: A randomised, double‐blind, active‐controlled trial

Abstract Background Atopic dermatitis (AD) is one of the most common inflammatory skin diseases. It is associated with significant itch and impaired quality of life. Systemic treatments are efficient but associated with side effects. Novel topical treatments with a favourable safety profile are needed. SNG100 is a novel composition of hydrocortisone 1% in a cream base comprising sulphated polysaccharide (SPS; extracted from in‐house cultivated Porphyridium Cruentum unicellular algae), a well‐known hydrating, moisturising and a skin barrier repairing agent. Objectives To assess the safety, usability and efficacy of SNG100 cream in patients aged ≥6 years with moderate AD. Methods In this proof of concept phase I, double‐blind, randomised trial, participants received one of three treatments for 14 days: SNG100 twice daily (BID), hydrocortisone 1% BID or mometasone furoate once daily (QD). The primary endpoint was the safety and tolerability of SNG100 cream compared to hydrocortisone 1% and mometasone furoate. The secondary endpoint was the subject's usability of SNG100. Exploratory efficacy endpoints included percent change from baseline in SCOring AD (SCORAD), Eczema Area and Severity Index, Patient‐Oriented Eczema Measure, Dermatology Life Quality Index, pruritus Numerical Rating Score (NRS), peak pruritus‐NRS and Investigator's Global Assessment. Subjects were also followed up without any treatment for additional 14 days. Results Overall, 66 participants were screened, and 60 patients were randomised. SNG100 demonstrated a high safety profile, similar to marketed products hydrocortisone 1% and mometasone furoate 0.1%, with no unanticipated drug safety related events. SNG100 and mometasone furoate 0.1% cream achieved almost similar and statistically significant greater percentage reductions from baseline in SCORAD as compared to hydrocortisone 1% cream. SNG100 demonstrated significant improvement in NRS as compared to hydrocortisone 1% cream. Remarkably, SNG100 led to a lasting effect with only 29.4% of subjects returning to IGA3 during the follow‐up period compared to 50% and 38.9% in the hydrocortisone 1% and in mometasone furoate treatment arms, respectively. Conclusions Topical SNG100 is an effective, safe, and well‐tolerated innovative treatment for moderate AD. Trial registration number: NCT04615962 (Topical Cream SNG100 for Treatment in Moderate AD Subjects)

Prevalence of sleep disorders among medical students of Umm Al-Qura University, Makkah, Kingdom of Saudi Arabia

Background: Sleep disorders are a common medical problem and can affect health and quality of life. There are multiple types of sleep disorders such as obstructive sleep apnea, insomnia, narcolepsy, restless legs/periodic limb movement disorder, circadian rhythm disorders, sleepwalking and nightmares. Medical students appear to be more liable to develop sleep disorders due to their high academic load. Design and Methods: This study seeks to estimate the prevalence of sleep disorders among Umm Al-Qura University medical students and associated risk factors. This cross-sectional study was conducted at the Faculty of Medicine of Umm Al-Qura University in Makkah, Saudi Arabia. A self administrated questionnaire was used to collect the data including socio-demographic data and sleep-50 questionnaire. Four hundred and thirty-eight (438) medical students from the second year to the sixth year were recruited to the study. Results: Three hundred and twenty-three participants (73.8%) complained of at least one sleep disorder. The most prevalent sleep disorder among students was narcolepsy at 226 (51.6%). Female students, second year students and students spending significant time watching television or on smartphones were more affected than others with p values of 0.001, 0.005, and 0.004, respectively. Conclusions: Sleep disorders are common among medical students. It is essential to detect and address them before their condition deteriorates