Filtered and graded Procesi extensions of rings

In this paper, we introduce filtered and graded Procesi extensions of filtered and graded rings as a natural modification of Procesi extensions of rings. We show that these extensions behave well from the geometric point of view

The Cholecystectomy As A Day Case (CAAD) Score: A Validated Score of Preoperative Predictors of Successful Day-Case Cholecystectomy Using the CholeS Data Set

Background Day-case surgery is associated with significant patient and cost benefits. However, only 43% of cholecystectomy patients are discharged home the same day. One hypothesis is day-case cholecystectomy rates, defined as patients discharged the same day as their operation, may be improved by better assessment of patients using standard preoperative variables. Methods Data were extracted from a prospectively collected data set of cholecystectomy patients from 166 UK and Irish hospitals (CholeS). Cholecystectomies performed as elective procedures were divided into main (75%) and validation (25%) data sets. Preoperative predictors were identified, and a risk score of failed day case was devised using multivariate logistic regression. Receiver operating curve analysis was used to validate the score in the validation data set. Results Of the 7426 elective cholecystectomies performed, 49% of these were discharged home the same day. Same-day discharge following cholecystectomy was less likely with older patients (OR 0.18, 95% CI 0.15–0.23), higher ASA scores (OR 0.19, 95% CI 0.15–0.23), complicated cholelithiasis (OR 0.38, 95% CI 0.31 to 0.48), male gender (OR 0.66, 95% CI 0.58–0.74), previous acute gallstone-related admissions (OR 0.54, 95% CI 0.48–0.60) and preoperative endoscopic intervention (OR 0.40, 95% CI 0.34–0.47). The CAAD score was developed using these variables. When applied to the validation subgroup, a CAAD score of ≤5 was associated with 80.8% successful day-case cholecystectomy compared with 19.2% associated with a CAAD score >5 (p < 0.001). Conclusions The CAAD score which utilises data readily available from clinic letters and electronic sources can predict same-day discharges following cholecystectomy

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

A report of NATO/CCMS working group on management of accidents involving the release of dioxins and related compounds

Papers delivered by the experts of the Working Group . . within the framework of NATO/CCMS Pilot Study Dioxin Problems. Report based on the results of the Plenary MeetingSIGLEITItal

Middle-East OBGYN Graduate Education (MOGGE) Foundation practice guidelines: prevention of group B Streptococcus infection in pregnancy and in newborn. Practice guideline no. 02-O-20

Rectovaginal colonization with group B streptococcus (GBS) is commonly encountered in pregnancy. GBS is the most common cause of early onset neonatal sepsis, which is associated with 12% case-fatality rate. Although screening protocols and prophylactic treatment are readily available worldwide, practice in low-resource countries is challenged by lack of awareness and limited implementation of these protocols. In addition, antibiotic susceptibility pattern may vary globally owing to different regulations of antibiotic prescription or prevalence of certain bacterial serotypes. This guideline appraises current evidence on screening and management of GBS colonization in pregnancy particularly in low-resource settings. © 2021 Informa UK Limited, trading as Taylor ; Francis Group.Middle-East Obstetrics and Gynecology Graduate Education (MOGGE) Foundation Practice Committee would like to thank Dr. AbuBakr Elnashar for providing input and advice on the final version of the manuscript, and would like to thank Dr. Mohamed Sabry, Dr. Shaimaa Gamal, and “up to date in obstetrics and gynecology” workgroup for facilitating provider-based surveys

Middle-East OBGYN graduate education (MOGGE) foundation practice guidelines: use of labor charts in management of labor. Practice guideline no. 04-O-21

Since the 50 s of the last century, labor charts have been proposed and appraised as a tool to diagnose labor abnormalities and guide decision-making. The partogram, the most widely adopted form of labor charts, has been endorsed by the world health organization (WHO) since 1994. Nevertheless, recent studies and systematic reviews did not support clinical significance of application of the WHO partogram. These results have led to further studies that investigate modifications to the structure of the partogram, or more recently, to reconstruct new labor charts to improve their clinical efficacy. This guideline appraises current evidence on use of labor charts in management of labor specially in low-resource settings. © 2021 Informa UK Limited, trading as Taylor ; Francis Group.Middle-East Obstetrics and Gynecology Graduate Education (MOGGE) Foundation would like to thank Dr. Mohamed Sabry, Dr. Shaimaa Gamal, and “uptodate in obstetrics and gynecology” workgroup for facilitating provider-based surveys

Upgrading combined anaerobic-aerobic UASB-FPU to UASB-DHS system: Cost comparison and performance perspective for developing countries

This study determined the performance of upgraded sewage treatment plant (STP) based on an anaerobic-aerobic system consisting Up-flow Anaerobic Sludge Blanket (UASB) reactor, Final Polishing Unit (FPU) and Down-flow Hanging Sponge (DHS) system, treating municipal wastewater located at Dhandhupura, Agra, Uttar Pradesh (India). The performance evaluation of STP were based on the removal efficiency of parameters like Biochemical Oxygen Demand (BOD), Chemical Oxygen Demand (COD), Total Suspended Solids (TSS) and Volatile Suspended Solids (VSS). The results exhibits improved BOD, COD, TSS and VSS removal efficiency for UASB-DHS system (92.01, 82.26, 91.02, 92.88) as compared to UASB-FPU (81.67, 74.35, 83.72, 83.41) respectively. In addition, this study compares the UASB-DHS system with other post-treatment methods based on their treatment cost and removal efficiency. The technology ranking analysis showed that the UASB-DHS system scored the highest desirability value of 6.77 followed by MBR and ASP technology having a score of 5.17 and 5.11 respectively. The results demonstrated that the UASB-DHS system outperformed the existing UASB-FPU system and met the Indian standards for effluent discharge i.e. BOD less than 30 mg/l. Therefore, the treated sewage can be considered for cultivation, irrigation purpose and safely discharged into water bodies. Moreover, the cost analysis indicates that the UASB-DHS system requires less energy in operation, low expenses in sludge handling and comparatively small area required for post-treatment operation. Hence, this work proposed an economical and efficient approach for the treatment of municipal wastewater particularly for developing countries. © 2020 Elsevier Lt