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

Analisis Karakteristik Campuran Aspal Panas Split Mastic Asphalt (SMA) menggunakan Bahan Tambah Buton Granular Asphalt (BGA) dan Tongkol jagung

Penelitian ini menganalisis pengaruh kualitas campuran aspal panas menggunakan Split Mastic Asphalt (SMA).  Hal ini bertujuan  untuk mengetahui karakteristik campuran Split Mastic Asphalt (SMA) pada penambahan Asbuton BGA dengan bahan tambah alami tongkol jagung sebagai filler. Variasi kadar selulosa dibuat 5 benda uji dengan total 20 sampel dengan penambahan 4 variasi selulosa tongkol jagung yakni 0.1%, 0.25%, 0.35%, 0.45%  dari total berat campuran. Pemadatan dilakukan dengan jumlah tumbukan sebanyak 2×50 tumbukan. Hasil uji menunjukan bahwa nilai stabilitas tertinggi berada pada 0 % penambahan selulosa tongkol jagung yakni 2737 kg dan nilai terendah berada pada 0.45 % penambahan selulosa tongkol jagung yakni 2109 kg. Nilai Density tertinggi berada pada 0 % adalah 2.11 gr/cm3 dan Nilai  Density terendah berada pada 0.45 % adalah 2.03 gr/cm3. Penelitian ini menurunkan nilai stabilitas dan density dari SMA,  namun hasil dari penelitian ini perlu kajian yang lebih mendalam

Ocorrência e caracterização molecular de Cryptosporidium em cordeiros Occurrence and molecular characterization of Cryptosporidium in lambs

The occurrence of Cryptosporidium in fecal samples of lambs was determined in order to test correlations among the type of animal raising, feces consistence, index of oocysts elimination, animal age, and molecular characterization of species and genotypes involved in this parasitism. A total of 460 fecal samples were collected from lambs during the first 30 days of life, in various screeds of 21 farms. All samples were analyzed using malachite green negative coloration stain under microscopy. For molecular characterization of Cryptosporidium, on positive samples under microscopy, a nested PCR protocol was used for amplification of fragmentts from 18S rRNA gene or actin gene. It was found 6.7% of animals expeling oocysts of Cryptosporidium in feces of eight farms, without statistics relation among the analyzed indexes. The species and genotype involved were C. parvum type A 18S rRNA, C. parvum type B 18S rRNA and cervid genotype, which present a zoonotic potential of disease