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

Enhanced bilirubin binding to different mammalian erythrocytes in the presence of magnesium ions

Effect of magnesium ions on the binding of bilirubin to erythrocytes of different mammalian species, namely, human, buffalo, goat and sheep was studied. Increase in the concentration of magnesium ions led to a gradual increase in the erythrocyte-bound bilirubin in both human and buffalo erythrocytes whereas in sheep and goat erythrocytes, the pronounced increase was found beyond 2.0 and 2.7 mM MgCI2 concentrations respectively. Percentage increase in erythrocyte-bound bilirubin was found highest in human erythrocytes followed by buffalo and sheep erythrocytes and minimum in goat erythrocytes. These differences in the binding of bilirubin to different mammalian erythrocytes can be attributed to the differential shielding effect of metal ions which involves the masking of negatively charged phosphate of phospholipids found on the erythrocyte surface

Mobility Management Issues and Solutions in 5G-and-Beyond Networks: A Comprehensive Review

The fully accomplished standardization of the new mobile generation has led to the deployment of fifth-generation (5G) wireless networks to gratify enormous traffic volume for Internet services. The current centralized mobility system could not be sufficient to manage an explosive increase in data volume and is considered a steadily rising issue in modern wireless communication. A new technique that can affluently handle traffic problems and completely avoid network breakdown chances is indispensable. Recently, distributed mobility management (DMM) was introduced to overcome the inevitable obstacles that destructively impact the existing networks. Specifically, a novel design based on the deployment of distributed mobility anchors, closer to the terminal points, was introduced. Several works have been proposed to build DMM solutions with different focuses for 5G-and-beyond networks (B5G), which are also referred to as sixth-generation solutions (6G). In this paper, we present the potential and benefits of flat network design for efficient and fast routing of traffic and furnish the effectiveness of the scheme toward mobility management in B5G by delineating recent research works. We also present the current limitations, challenges, and future research directions for seamless mobility to achieve the desired objectives in the current 5G and upcoming 6G cellular communications

Enhanced bilirubin binding to different mammalian erythrocytes in the presence of magnesium ions

Effect of magnesium ions on the binding of bilirubin to erythrocytes of different mammalian species, namely, human, buffalo, goat and sheep was studied. Increase in the concentration of magnesium ions led to a gradual increase in the erythrocyte-bound bilirubin in both human and buffalo erythrocytes whereas in sheep and goat erythrocytes, the pronounced increase was found beyond 2.0 and 2.7 mM MgCl(2) concentrations respectively. Percentage increase in erythrocyte-bound bilirubin was found highest in human erythrocytes followed by buffalo and sheep erythrocytes and minimum in goat erythrocytes. These differences in the binding of bilirubin to different mammalian erythrocytes can be attributed to the differential shielding effect of metal ions which involves the masking of negatively charged phosphate of phospholipids found on the erythrocyte surface

Borislav Runanine as the Friend of the Prince (centre), Tamara Toumanova as the Queen of the Swans (centre), Paul Petroff as the Prince (centre right), and artists of the company, in Le lac des cygnes, the Original Ballet Russe, Australian tour, His Majesty's Theatre, Melbourne, 1940 [picture] /

From: Le lac des cygnes (Swan lake) : choreographic poem in one act / music by Peter Ilich Tchaikovsky; Part of the collection: Hugh P. Hall collection of photographs, 1938-1940.; Performed March and April 1940. No number on front. 3P/9 on reverse.; Choreography after M. Petipa ; scenery and costumes by C. Korovine ; scenery executed by O. Allegri.; Also available in an electronic version via the internet at: http://nla.gov.au/nla.pic-vn4175672. One of a collection of photographs taken by Hugh P. Hall of 28 ballet productions performed by the Covent Garden Russian Ballet (toured Australia 1938-1939) and the Original Ballet Russe (toured Australia 1939-1940). These are the second and third of the three Ballets Russes companies which toured Australasia between 1936 and 1940. The photographs were taken from the auditorium during a live performance in His Majesty's Theatre, Melbourne and mounted on cardboard for display purposes. For conservation and storage, the photographs have been demounted. The original arrangement of the photographs has been recorded, and details are available from the Pictures Branch of the National Library

Strategies to manage hepatitis C virus infection disease burden - volume 3.

To access publisher's full text version of this article click on the hyperlink at the bottom of the pageThe hepatitis C virus (HCV) epidemic was forecasted through 2030 for 15 countries in Europe, the Middle East and Asia, and the relative impact of two scenarios was considered: increased treatment efficacy while holding the annual number of treated patients constant and increased treatment efficacy and an increased annual number of treated patients. Increasing levels of diagnosis and treatment, in combination with improved treatment efficacy, were critical for achieving substantial reductions in disease burden. A 90% reduction in total HCV infections within 15 years is feasible in most countries studied, but it required a coordinated effort to introduce harm reduction programmes to reduce new infections, screening to identify those already infected and treatment with high cure rate therapies. This suggests that increased capacity for screening and treatment will be critical in many countries. Birth cohort screening is a helpful tool for maximizing resources. Among European countries, the majority of patients were born between 1940 and 1985. A wider range of birth cohorts was seen in the Middle East and Asia (between 1925 and 1995).Gilead Sciences Center for Disease Analysi

Historical epidemiology of hepatitis C virus (HCV) in select countries - volume 3.

To access publisher's full text version of this article click on the hyperlink at the bottom of the pageDetailed, country-specific epidemiological data are needed to characterize the burden of chronic hepatitis C virus (HCV) infection around the world. With new treatment options available, policy makers and public health officials must reconsider national strategies for infection control. In this study of 15 countries, published and unpublished data on HCV prevalence, viraemia, genotype, age and gender distribution, liver transplants and diagnosis and treatment rates were gathered from the literature and validated by expert consensus in each country. Viraemic prevalence in this study ranged from 0.2% in Iran and Lebanon to 4.2% in Pakistan. The largest viraemic populations were in Pakistan (7 001 000 cases) and Indonesia (3 187 000 cases). Injection drug use (IDU) and a historically unsafe blood supply were major risk factors in most countries. Diagnosis, treatment and liver transplant rates varied widely between countries. However, comparison across countries was difficult as the number of cases changes over time. Access to reliable data on measures such as these is critical for the development of future strategies to manage the disease burden.Gilead Sciences Center for Disease Analysi