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

Some Finite Sums Involving Generalized Fibonacci and Lucas Numbers

By considering Melham's sums (Melham, 2004), we compute various more general nonalternating sums, alternating sums, and sums that alternate according to (−1)2+1 involving the generalized Fibonacci and Lucas numbers

Determination of calpastatin (CAST) gene polimorphism in some native sheep breeds reared in Turkey by PCR-RFLP method [Türkiye’de yetiştirilen bazı yerli koyun irklarında kalpastatin (CAST) geni polimorfizminin PCR-RFLP yöntemiyle belirlenmesi]

In this study, calpastatin (CAST) gene polimorphism was investigated in 7 native sheep breeds reared in Turkey by using PCR-RFLP method. The frequencies of M and N alleles of CAST gene in Kangal (n= 31), Awassi (n= 26), Güney Karaman (n= 23), Akkaraman (n= 21), Morkaraman (n= 34), Karayaka (n= 33), and Karakas (n= 22) sheep breeds were determined as 0.92-0.08, 0.59-0.41, 0.67-0.33, 0.69-0.31, 0.87-0.13, 0.86-0.14, 0.89-0.11 respectively. According to chi-square test, all the other populations were consistent with Hardy-Weinberg equilibrium, whereas Morkaraman, İvesi and Karayaka populations showed significant (P<0.05) deviation from Hardy-Weinberg equilibrium for the CAST gene. © Ankara Üniversitesi Ziraat Fakültesi