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

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

Characteristics of the clinical and global neurosurgical research publications from Africa: A scoping review

Introduction: Scientific research has a direct, profound impact on healthcare systems worldwide. While an upward trend can be observed in the number of produced papers in the neurosurgical specialty, disparities still exist between African neurosurgeons on one side and between African neurosurgeons and neurosurgeons from high income countries, on the other. Research question: This study aims to analyze neurosurgical research produced in Africa to identify gaps in the literature and provide recommendations for aspiring African neurosurgeons for essential research areas. Materials and methods: Four electronic databases (PubMed, Scopus, Web of Science, and Embase) were systematically searched for relevant articles on neurosurgery published by African authors. The three main inclusion criteria were: Articles published in the Neurosurgical field, articles published by African authors (whether first authors or co-authors) and articles published in Africa. Data extracted included the study design, scope, neurosurgical subspecialty, and the authors' nationalities. Results: A total of 982 articles were included in the analysis. Of these articles, 889 (90.6%) were primary, 48 (4.9%) secondary, and 44 (4.5%) other types of research. Global Neurosurgery papers represent 7% of African neurosurgery research output. Most common primary studies included retrospective cohort (32.4%), case reports (28.3%), and prospective cohort (13.8%) studies. The most common secondary research articles were literature reviews (4.9%), letters to the editor (1.2%), and systematic reviews and meta-analyses (0.8%). Common research areas were neuro-oncology 242 (24.7%), spinal surgery 157 (16%), and cerebrovascular (14%). The most common nationalities of the first authors were Egyptian (32.4%), Moroccan (15%), and Nigerian (14.2%). Discussion and conclusion: This study identifies increased African authorship in neurosurgical research in recent years. Nevertheless, many countries still lack representation in the neurosurgical research scene. Furthermore, a high percentage of the published papers is of low evidence. Therefore, we recommend that African neurosurgical researchers focus more on clinical trials and systematic reviews that directly translate to improving clinical practice. African neurosurgeons should also consider more collaboration between African authors

Valorization of carob waste: Definition of a second-generation bioethanol production process

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Insights into head and neck cancer research in Egypt: A scoping review

Background: Head and neck cancer (HNC) encompasses malignant tumors in areas like the oral cavity, pharynx, and larynx. This analysis identifies strengths and deficiencies in HNC research, aiming to improve published papers' quality, quantity, and diversity. It also encourages more participation from oncologists, particularly in Egypt, to bridge the gap with Western healthcare standards. Methods: A systematic search was conducted in databases including PubMed, Scopus, Web of Science, and Embase. The goal was to gather research articles on HNC in Egypt published from January 1, 2000, to December 31, 2022. Results: From 2150 articles, 1329 were screened by title and abstract, leading to 193 for full-text review. Finally, 174 articles were included in the final analysis. 2020 saw the highest number of publications. The majority were primary research articles, with randomized controlled trials being prevalent. Most studies were clinical, focusing on radiotherapy, and involved adult patients, emphasizing service delivery. Publications were predominantly in non-Egyptian journals, with the Egyptian Journal of Radiology and Nuclear Medicine being the most frequent. Research was mainly conducted by Egyptian authors and at Cairo University. Conclusion: The growing prevalence of HNC in Egypt underscores the need for more comprehensive research on its various aspects, including etiology, risk factors, and prevention. There's a call for increased research outputs at different Egyptian universities, multicenter studies, and international collaborations. This approach can improve the understanding and management of HNC, contributing to global discussions and advancing treatment and prevention strategies in Egypt