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

Enhancement of Metabolite Production in High-Altitude Microalgal Strains by Optimized C/N/P Ratio

This study evaluated the role of C/N/P in the increase in the synthesis of carbohydrates, proteins, and lipids in two high-mountain strains of algae (Chlorella sp. UFPS019 and Desmodesmus sp. UFPS021). Three carbon sources (sodium acetate, sodium carbonate, and sodium bicarbonate), and the sources of nitrogen (NaNO3) and phosphate (KH2PO4 and K2HPO4) were analyzed using a surface response (3 factors, 2 levels). In Chlorella sp. UFPS019, the optimal conditions to enhance the synthesis of carbohydrates were high sodium carbonate content (3.53 g/L), high KH2PO4 and K2HPO4 content (0.06 and 0.14 g/L, respectively), and medium-high NaNO3 (0.1875 g/L). In the case of lipids, a high concentration of sodium acetate (1.19 g/L) coupled with high KH2PO4 and K2HPO4 content (0.056 and 0.131 g/L, respectively) and a low concentration of NaNO3 (0.075 g/L) drastically induced the synthesis of lipids. In the case of Desmodesmus sp. UFPS021, the protein content was increased using high sodium acetate (2 g/L), high KH2PO4 and K2HPO4 content (0.056 and 0.131 g/L, respectively), and high NaNO3 concentration (0.25 g/L). These results demonstrate that the correct adjustment of the C/N/P ratio can enhance the capacity of high-mountain strains of algae to produce high concentrations of carbohydrates, proteins, and lipids

Enhancement of Metabolite Production in High-Altitude Microalgal Strains by Optimized C/N/P Ratio

This study evaluated the role of C/N/P in the increase in the synthesis of carbohydrates, proteins, and lipids in two high-mountain strains of algae (Chlorella sp. UFPS019 and Desmodesmus sp. UFPS021). Three carbon sources (sodium acetate, sodium carbonate, and sodium bicarbonate), and the sources of nitrogen (NaNO3) and phosphate (KH2PO4 and K2HPO4) were analyzed using a surface response (3 factors, 2 levels). In Chlorella sp. UFPS019, the optimal conditions to enhance the synthesis of carbohydrates were high sodium carbonate content (3.53 g/L), high KH2PO4 and K2HPO4 content (0.06 and 0.14 g/L, respectively), and medium-high NaNO3 (0.1875 g/L). In the case of lipids, a high concentration of sodium acetate (1.19 g/L) coupled with high KH2PO4 and K2HPO4 content (0.056 and 0.131 g/L, respectively) and a low concentration of NaNO3 (0.075 g/L) drastically induced the synthesis of lipids. In the case of Desmodesmus sp. UFPS021, the protein content was increased using high sodium acetate (2 g/L), high KH2PO4 and K2HPO4 content (0.056 and 0.131 g/L, respectively), and high NaNO3 concentration (0.25 g/L). These results demonstrate that the correct adjustment of the C/N/P ratio can enhance the capacity of high-mountain strains of algae to produce high concentrations of carbohydrates, proteins, and lipids

Assessing Lung Cancer Incidence Disparities Between Puerto Ricans and Other Racial/Ethnic Groups in the United States, 1992–2010

This study compared the incidence of lung cancer among Puerto Ricans (PRs) with that of Whites, Blacks, and Hispanics in the United States. We computed age-standardized rates of lung cancer during 1992–2010 and percentages of change over time. Standardized rate ratios (SRR) were estimated to assess racial/ethnic and gender differences. All men groups showed a significant decline in lung cancer over time but PRs observed the smallest change (−1.2%). For both men and women, PRs had lower incidence rates compared to other racial/ethnic groups (SRR<1; P<0.05). Among all groups, men reported higher incidence rates than women but PRs showed the largest gender disparity (SRR=2.29). This study showed that although PRs exhibited lower incidence rates of lung cancer, this subgroup of Hispanics faced a high burden of lung cancer, principally because PR men had the smallest decline over time and the largest gender difference among all groups

Geomechanical substantiation of reuse feasibility of development workings for coal mines

Дисертація на здобуття наукового ступеня кандидата технічних наук за спеціальністю 05.15.09 – «Геотехнічна і гірнича механіка». Державний вищий навчальний заклад «Національний гірничий університет», Дніпропетровськ, 2016.В дисертації обґрунтувані такі параметри комбінованої системи кріплення і охоронної конструкції на сполученні «штрек–лава», при яких можлива економічно доцільна повторна експлуатація підготовчих виробок в гірничо–геологічних умовах шахт ДП «Селідіввугілля». В результаті натурних вимірювань встановлено, що величина залишкового перерізу може виступати критерієм, що характеризує доцільність для повторного використання конвеєрного штреку на суміжній лаві. Такою величиною є залишкова площа в світлі, що дорівнює 8,5 м2. На основі обґрунтованого критерію вирішена чисельна задача про вплив різних систем охорони на НДС геомеханічної системи «кріплення – охоронна конструкція – масив». Встановлено, що при використанні охоронної конструкції у вигляді накатного костра зі шпального бруса в сукупності з дворівневою системою рамно–анкерного кріплення за лавою забезпечується збереження перерізу підготовчої виробки, що призначена для повторного використання. Досліджено вплив куту нахилу пласта на параметри прийнятої геомеханічної системи. Розробки були успішно реалізовані в промисловості з економічним ефектом 2 422 грн./м виробки.Цель работы состоит в геомеханическом обосновании таких параметров комбинированной системы крепи и охранной конструкции на сопряжении «штрек – лава», при которых возможна экономически целесообразная повторная эксплуатация подготовительных выработок в горно - геологических условиях шахт ГП «Селидовуголь». В качестве основного объекта исследований выбрана шахта «1/3 Новогродовская» ГП «Селидовуголь», где были выполнены комплексные исследования, заключавшиеся в визуальном обследовании ряда горных выработок, организации инструментальных наблюдений на замерных станциях, решении аналитических задач, а также проведении экспертной оценки состояния выемочных штреков и анализе архивных данных. В результате выполнения комплекса натурных измерений определены основные виды проявлений горного давления и ремонтных работ в подготовительных выработках, построены зависимости развития геомеханических процессов в их окрестности во времени и установлено, что величина остаточного сечения может выступать тем критерием, который характеризует целесообразность для повторного использования конвейерного штрека на смежной лаве. Критериальной величиной экономической рациональности повторного использования штрека является остаточная площадь в свету, равная 8,5 м2. На основе обоснованного критерия решена численная задача о влияние различных систем охраны на НДС геомеханической системы «крепь – охранная конструкция – массив». Установлено, что при использовании охранных конструкции в виде накатного костра из шпального бруса, выбраной по комплексу критериев «геомеханическая эффективность», «стоимость», «технологичность», в совокупности с двухуровневой системой рамно - анкерной крепи на основе сталеполимерных и канатных анкеров, за лавой обеспечивается сохранение сечения подготовительной выработки, применяемой для повторного использования. Такая система «крепь – охранная конструкция» принята как базовая. В горно–геологических условиях шахт Красноармейского промышленного района величина остаточного сечения конвейерного штрека, принятая в качестве критерия повторного использования подготовительных выработок, уменьшается при увеличении угла падения угольных пластов по линейному закону, что позволяет на этой основе корректировать базовый вариант системы крепи и охранной конструкции. Результаты внедрены в виде Рекомендации по геомеханическому обоснованию параметров рамно - анкерной крепи подготовительных выработок угольных шахт при отработке выемочного участка 18 южной лавы пл. l1 шахты «1/3 Новогродовская» и «Методики численного моделирования рамно –анкерной крепи подготовительных и капитальных выработок угольных шахт ГП «Селидовуголь», а также использованы в учебном процессе ГВУЗ «НГУ» при подготовке студентов ступеней «бакалавр» и «магистр» и образовательно–квалификационного уровня «специалист». Выполненная оценка экономической эффективности предложенных тех-нических решений, обеспечивающих повторное использование штрека показала, что ожидаемый экономический эффект, составляет 2422 грн./м выработки.The research purpose is geomechanical substantiation of such parameters of combined system of lining and support on the roadhead of roadway and longwall through which is possible and economically feasible to ensure the reuse of development workings under the mining and geological conditions of "Selidovugol" mines. As a result of the in–situ measurements revealed that the value of the remaining area can be a criteria that characterizes the feasibility for belt road reusing to adjacent longwall. Such value is the remaining area in the light that equal to 8.5 m2. On the basis of justified criteria the influence of various support systems on stress–deformed state of the geomechanical system "lining – support – array" was solved. It is established that a residual inside half–timbers of roadway can act the criteria that characterize suitable for reuse in development workings adjacent to the longwall. Economic rationality criteria for reuse roadway is a residual inside half–timbers, equal to 8.5 m2. It was found that by using a support system in the form of sawed stick crib, with the two – tier system of frame – bolt lining the criteria for development workings reuse was performed over the longwall. The influence of the angle of the bed at the geomechanical system parameters was adopted. The developments were successfully implemented and approbated. Economic effect is 2422 UAH on 1m

Measurements of the branching fractions of Λc+→pπ−π+\Lambda_{c}^{+} \rightarrow p \pi^{-} \pi^{+}, Λc+→pK−K+\Lambda_{c}^{+} \rightarrow p K^{-} K^{+}, and Λc+→pπ−K+\Lambda_{c}^{+} \rightarrow p \pi^{-} K^{+}

International audienceThe ratios of the branching fractions of the decays Λ$_{c}^{+}$  → pπ$^{−}$π$^{+}$, Λ$_{c}^{+}$  → pK$^{−}$K$^{+}$, and Λ$_{c}^{+}$  → pπ$^{−}$K$^{+}$ with respect to the Cabibbo-favoured Λ$_{c}^{+}$  → pK$^{−}$π$^{+}$ decay are measured using proton-proton collision data collected with the LHCb experiment at a 7 TeV centre-of-mass energy and corresponding to an integrated luminosity of 1.0 fb$^{−1}$: \begin{array}{l}\frac{\mathrm{\mathcal{B}}\left({\varLambda}_c^{+}\to p{\pi}^{-}{\pi}^{+}\right)}{\mathrm{\mathcal{B}}\left({\varLambda}_c^{+}\to p{K}^{-}{\pi}^{+}\right)}=\left(7.44\pm 0.08\pm 0.18\right)\%,\hfill \\ {}\frac{\mathrm{\mathcal{B}}\left({\varLambda}_c^{+}\to p{K}^{-}{K}^{+}\right)}{\mathrm{\mathcal{B}}\left({\varLambda}_c^{+}\to p{K}^{-}{\pi}^{+}\right)}=\left(1.70\pm 0.03\pm 0.03\right)\%\hfill \\ {}\frac{\mathrm{\mathcal{B}}\left({\varLambda}_c^{+}\to p{\pi}^{-}{K}^{+}\right)}{\mathrm{\mathcal{B}}\left({\varLambda}_c^{+}\to p{K}^{-}{\pi}^{+}\right)}=\left(0.165\pm 0.015\pm 0.005\right)\%,\hfill \end{array} where the uncertainties are statistical and systematic, respectively. These results are the most precise measurements of these quantities to date. When multiplied by the world-average value for $\mathrm{\mathcal{B}}\left({\varLambda}_c^{+}\to p{K}^{-}{\pi}^{+}\right)$ , the corresponding branching fractions are \begin{array}{l}\mathrm{\mathcal{B}}\left({\varLambda}_c^{+}\to p{\pi}^{-}{\pi}^{+}\right)=\left(4.72\pm 0.05\pm 0.11\pm 0.25\right)\times {10}^{-3},\hfill \\ {}\mathrm{\mathcal{B}}\left({\varLambda}_c^{+}\to p{K}^{-}{K}^{+}\right)=\left(1.08\pm 0.02\pm 0.02\pm 0.06\right)\times {10}^{-3},\hfill \\ {}\mathrm{\mathcal{B}}\left({\varLambda}_c^{+}\to p{\pi}^{-}{K}^{+}\right)=\left(1.04\pm 0.09\pm 0.03\pm 0.05\right)\times {10}^{-4},\hfill \end{array} where the final uncertainty is due to $\mathrm{\mathcal{B}}\left({\varLambda}_c^{+}\to p{K}^{-}{\pi}^{+}\right)$

Measurement of the ratio of the B0→D∗−τ+ντB^0 \to D^{*-} \tau^+ \nu_{\tau} and B0→D∗−μ+νμB^0 \to D^{*-} \mu^+ \nu_{\mu} branching fractions using three-prong τ\tau-lepton decays

International audienceThe ratio of branching fractions R(D*-)≡B(B0→D*-τ+ντ)/B(B0→D*-μ+νμ) is measured using a data sample of proton-proton collisions collected with the LHCb detector at center-of-mass energies of 7 and 8 TeV, corresponding to an integrated luminosity of 3  fb-1. For the first time, R(D*-) is determined using the τ-lepton decays with three charged pions in the final state. The B0→D*-τ+ντ yield is normalized to that of the B0→D*-π+π-π+ mode, providing a measurement of B(B0→D*-τ+ντ)/B(B0→D*-π+π-π+)=1.97±0.13±0.18, where the first uncertainty is statistical and the second systematic. The value of B(B0→D*-τ+ντ)=(1.42±0.094±0.129±0.054)% is obtained, where the third uncertainty is due to the limited knowledge of the branching fraction of the normalization mode. Using the well-measured branching fraction of the B0→D*-μ+νμ decay, a value of R(D*-)=0.291±0.019±0.026±0.013 is established, where the third uncertainty is due to the limited knowledge of the branching fractions of the normalization and B0→D*-μ+νμ modes. This measurement is in agreement with the standard model prediction and with previous results

Study of prompt D0^{0} meson production in ppPb collisions at sNN=5 \sqrt{s_{\mathrm{NN}}}=5 TeV

International audienceProduction of prompt D$^{0}$ mesons is studied in proton-lead and lead-proton collisions recorded at the LHCb detector at the LHC. The data sample corresponds to an integrated luminosity of 1.58±0.02 nb$^{−1}$ recorded at a nucleon-nucleon centre-of-mass energy of $\sqrt{s_{\mathrm{NN}}}=5$ TeV. Measurements of the differential cross-section, the forward-backward production ratio and the nuclear modification factor are reported using D$^{0}$ candidates with transverse momenta less than 10 GeV/c and rapidities in the ranges 1.5 < y$^{∗}$ < 4.0 and −5.0 < y$^{∗}$ < −2.5 in the nucleon-nucleon centre-of-mass system