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

The treatment of municipal wastewater by the macroalga Oedogonium sp and its potential for the production of biocrude

Municipal wastewater represents a significant yet under-utilised resource for the commercial production of algae. However, in order to realise this potential, two constraints must first be addressed - the treatment of wastewater to levels comparable with existing technologies and the reliable production of monocultures as the basis for commercial products. In this study, three municipal wastewater sources were investigated at various water exchange rates for the cultivation of the filamentous freshwater macroalga Oedogonium sp., demonstrating that the delivery of nutrients through primary effluent at a low exchange rate of 5% volume per day supported high biomass productivity. A continuous high-density culture of Oedogonium (0.25-1.5 g/L fresh weight) in a pilot-scale pond system yielded biomass productivities of 7-10 g/m(2)/d dry weight and nutrient removal rates of 0.50 g nitrogen/m(2)/d and 0.11 g phosphorus/m(2)/d without the addition of CO2. Nitrogen, phosphorus and chemical oxygen demand were reduced by 62%, 75% and 57% respectively in the treated water. The concentration of microbes was reduced by 99% and some metal contaminants that can impede the reuse of treated water were also reduced by 99%. The biomass produced had a relatively consistent biochemical composition that would yield 26-27% of the dry weight as biocrude oil through hydrothermal liquefaction. The results demonstrate that monocultures of Oedogonium sp. can be used to treat multiple components of municipal wastewater and simultaneously deliver biomass that can be conveniently harvested and converted to biocrude for the production of drop-in fuels

Estructura y diversidad de especies leñosas del matorral espinoso tamaulipeco regenerado postganadería en el noreste de México

Abstract: The aim of this research was to evaluate the structure and plant diversity of tree and shrub species of an area with a history of livestock use in the Tamaulipan Thornscrub. In 2012, 20 years after being suspended livestock activity, four sampling sites were established 1 600 m2. In the sampling sites it was conducted a census of all woody species, recording dasometric information as total height (h), basal diameter (d 0.10 m) and canopy diameter (d copa). According to the results we registered 12 species belonging to 12 genera and 7 families. The Fabaceae family has the highest number of species with 6 species. The height ranging from 0.5 to 12.4 m, it has a basal area of 13.76 m2/ha, and a canopy area of 5 271 m2/ha and a density of 1 156 N/ha. The species with greater ecological weight according to the index of importance value is Vachellia farnesiana with 60.49% of this value, which it’s the most dominant representing 81.08% of the canopy cover of all species in the study area. It registered a value of H' of 0.86 and a value of D Mg of 1.66. According to the graph of rank abundance distribution community it has a geometric model, which is dominated by the high presence of the species V. farnesiana.Resumen: El objetivo de la presente investigación fue evaluar la estructura y diversidad vegetal de las especies arbóreas y arbustivas de un área con historial de uso pecuario en el matorral espinoso tamaulipeco. En el año de 2012, 20 años después de ser suspendida la actividad pecuaria, se establecieron cuatro sitios de muestreo de 1 600 m2. En cada sitio se realizó un censo de todas las especias leñosas, registrando información dasométrica de altura total (h), diámetro basal (d 0.10 m) y diámetro de copa (d copa). Se registraron 12 especies pertenecientes a 12 géneros y siete familias. La familia más dominante fue Fabaceae con seis especies. La altura total oscila entre los 0.5 a 12.4 m, cuenta con un área basal de 13.76 m2/ha, un área de copa de 5 271 m2/ha y una densidad de 1 156 N/ha. La especie con mayor peso ecológico según el índice de valor de importancia es Vachellia farnesiana con 60.49% de dicho valor, la cual es la más dominante representando el 81.08% de la cobertura de copa de todas las especies del área de estudio. Se registró un valor de H´ de 0.86 y un valor de D Mg de 1.66, los cuales son considerados bajos en comparación con comunidades maduras. De acuerdo a la comparación de rango-abundancia, la comunidad presenta una distribución de modelo geométrico, ya que está dominada por la alta presencia de la especie V. farnesiana

Clinical and molecular aspects of familial hypercholesterolemia in Ibero-American countries

BACKGROUND: There is little information about familial hypercholesterolemia (FH) epidemiology and care in Ibero-American countries. The Ibero-American FH network aims at reducing the gap on diagnosis and treatment of this disease in the region. OBJECTIVE: To describe clinical, molecular, and organizational characteristics of FH diagnosis in Argentina, Brazil, Chile, Colombia, Mexico, Portugal, Spain, and Uruguay. METHODS: Descriptive analysis of country data related to FH cascade screening, molecular diagnosis, clinical practice guidelines, and patient organization presence in Ibero-America. RESULTS: From a conservative estimation of an FH prevalence of 1 of 500 individuals, there should be 1.2 million heterozygous FH individuals in Ibero-America and roughly 27,400 were diagnosed so far. Only Spain, Brazil, Portugal, and Uruguay have active cascade screening programs. The prevalence of cardiovascular disease ranged from 10% to 42% in member countries, and the highest molecular identification rates are seen in Spain, 8.3%, followed by Portugal, 3.8%, and Uruguay with 2.5%. In the 3 countries with more FH patients identified (Spain, Portugal, and Brazil) between 10 and 15 mutations are responsible for 30% to 47% of all FH cases. Spain and Portugal share 5 of the 10 most common mutations (4 in low density lipoprotein receptor [LDLR] and the APOB3527). Spain and Spanishspeaking Latin American countries share 6 of the most common LDLR mutations and the APOB3527. LDL apheresis is available only in Spain and Portugal and not all countries have specific FH diagnostic and treatment guidelines as well as patient organizations. CONCLUSIONS: Ibero-American countries share similar mutations and gaps in FH care.info:eu-repo/semantics/publishedVersio

Influência da temperatura do ar de secagem no calor latente de vaporização de água em feijão macassar (Vigna unguiculata (L.) Walp.), variedade sempre-verde Influence of the temperature on the latent heat of vaporization of moisture from cowpea (Vigna unguiculata (L.) Walp.), always-green variety

Em cálculos da quantidade de energia requerida em processos de secagem artificial de um produto agrícola, é necessário o conhecimento de uma expressão para a determinação do calor latente de vaporização (H) de água no produto. Normalmente, as expressões para H, encontradas na literatura, são dadas pelo calor latente de vaporização (h) de água livre multiplicado por funções que dependem apenas do teor de água do produto. Isso significa que a relação H/h, para um dado produto, só depende do teor de água, o que é uma simplificação, pois se sabe que tal relação depende também da temperatura. Neste artigo, é apresentada uma expressão para o cálculo de H para feijão macassar, variedade sempre-verde, levando em consideração a dependência de H/h com a temperatura. Para tal, foi desenvolvido e utilizado um programa computacional que ajusta, de forma automática, cerca de 500 funções contidas em sua biblioteca, com uma e duas variáveis independentes, a dados experimentais. O programa, que usa regressão não-linear, classifica as melhores funções ajustadas pelo critério do menor qui-quadrado reduzido. O conjunto de testes estatísticos realizados indica que a expressão apresentada neste artigo produz resultados mais precisos na determinação de H para feijão macassar que os de outras equações normalmente encontradas na literatura.<br>In order to determine the energy needed to artificially dry an agricultural product the latent heat of vaporization of moisture in the product, H, must be known. Generally, the expressions for H reported in the literature are of the form H = h(T)f(M), where h(T) is the latent heat of vaporization of free water, and f(M) is a function of the equilibrium moisture content, M, which is a simplification. In this article, a more general expression for the latent heat of vaporization, namely H = g(M,T), is used to determine H for cowpea, always-green variety. For this purpose, a computer program was developed which automatically fits about 500 functions, with one or two independent variables, imbedded in its library to experimental data. The program uses nonlinear regression, and classifies the best functions according to the least reduced chi-squared. A set of executed statistical tests shows that the generalized expression for H used in this work produces better results of H for cowpea than other equations found in literature