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

Cookers for solar homes

Means of piping solar energy into kitchens were investigated. Two different solar cookers utilising the heat-pipe principle were designed, constructed and tested. A cooker utilising an east-west line focusing collector, designated Mecca-1, was developed for this purpose. The second cooker was a flat-plate heat-pipe cooker, Mecca-2. A single heat pipe in each cooker absorbed the energy at the collector, transported it into the kitchen and delivered it to an insulated oven at the condenser end. Various heating and boiling experiments conducted on the two cookers demonstrated the feasibility of the concept. It was found that the Mecca-2 cooker with triple glazing had a utilisation efficiency of up to 19 per cent and could boil 1 litre of water in 27 min for a solar insolation of 900 W/m2.

Impacts of nano-emulsified vegetable oil on growth, hemato-biochemical markers, oxidative stress, and gut microbiota of New Zealand white and V-line rabbits

The present study aimed to examine the impact of magic oil® (a nano-emulsified vegetable oil) (NEVO) on growth and carcass traits, serum metabolites, and intestinal microbiota of New Zealand White (NZW) and V-line rabbits. A total of 450 rabbits of both breeds (male, five weeks old) with a 700 ± 19 g average live body weight was uniformly distributed into six groups (75 rabbits per each). Each group was subdivided into five replicates, each of 15 rabbits. Animals randomly allocated into a two × three completely factorial design (two breeds: NZW and V-line, and three treatments of NEVO: control (0.0), 0.5, and 1.0 ml of NEVO per liter of water, respectively). The findings of the present study revealed that V- line rabbits recorded a significant increase in the final body weight, final body weight gain, and total feed conversion ratio, along with carcass traits when compared to New Zealand White (NZW). Comapred with the control group, the final body weight, final body weight gain, and carcass traits of rabbits, orally supplemented with NEVO were significantly improved. At the same time, feed intake was not significantly improved. The effect of the NEVO supplement and its association with the breed (p < 0.001) have improved significantly the final body weight, final body weight gain, feed conversion ratio and carcass characteristics. A significant improvement in serum and tissue metabolites was observed with increasing NEVO levels. A remarkable increase in the serum total protein and globulin associated with a significant reduction (p < 0.001) in the serum total lipids and total cholesterol levels were also noticed with increasing NEVO levels. Total bacterial count, and the population of Escherichia coli and lactobacilli in the jejunum and colon were significantly (p < 0.001) lower in both rabbit breeds supplemented with NEVO than that of the control group. Based on these findings, supplementation of NEVO enhanced growth, antioxidant status and minimized pathogenic bacteria in rabbits