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[Display omitted] • An Implicit knowledge-guided machine learning framework is proposed. • The effect is validated by modelling plasma gasification of medical waste. • RMSEs decrease by 36.44% and 2.58% for ANN and SVM. • Knowledge-based errors decrease by 83.22% and 100% for ANN and SVM. • All implicit knowledge-based monotonicity relationships are captured. Ensuring the interpretability of machine learning models in chemical engineering remains challenging due to inherent limitations and data quality issues, hindering their reliable application. In this study, a qualitatively implicit knowledge-guided machine learning framework is proposed to improve plasma gasification modelling. Starting with a pre-trained machine learning model, parameters are further optimized by integrating the heuristic algorithm to minimize the data fitting errors and resolving implicit monotonic inconsistencies. The latter is comprehensively quantified through Monte Carlo simulations. This framework is adaptive to different machine learning techniques, exemplified by artificial neural network (ANN) and support vector machine (SVM) in this study. Validated by a case study on plasma gasification, the results reveal that the improved models achieve better generalizability and scientific interpretability in predicting syngas quality. Specifically, for ANN, the root mean square error (RMSE) and knowledge-based error (KE) reduce by 36.44% and 83.22%, respectively, while SVM displays a decrease of 2.58% in RMSE and a remarkable 100% in KE. Importantly, the improved models successfully capture all desired implicit monotonicity relationships between syngas quality and feedstock characteristics/operating parameters, addressing a limitation that traditional machine learning struggles with. [ABSTRACT FROM AUTHOR]

Introduction: The disposal of regulated medical waste (RMW) in the healthcare setting can be both costly and environmentally harmful. Prior studies have found large amounts of waste disposed of in RMW containers are inappropriately placed. Few studies to date have investigated the efficacy of waste reduction practices in the dermatology setting. Methods: This study aims to evaluate the effectiveness of a practice-wide intervention in reducing RMW in the outpatient dermatology setting. By performing daily waste audits and two concurrent educational interventions, the amount of RMW produced and percent of appropriately placed RMW will be measured. Further analysis will occur by comparing pre-intervention values to post-intervention values. Results: The percentage of waste properly placed in RMW containers prior to any intervention was 11%. Following both educational interventions, the percentage of waste properly placed in RMW containers increased by 56.1% (CI 43.7–68.5%) and the percentage of total waste produced that was identified and disposed of as RMW decreased by 6.0% (95% CI 1.2–10.8%). Conclusion: Our study provides practical data for dermatology providers to make small changes which can result in significant reductions of regulated medical waste, potentially providing benefits to the environment and cost-savings. [ABSTRACT FROM AUTHOR]

Background: Acute care of patients in the emergency department (ED) can be very challenging when patients attend EDs without their important medical information. This is especially problematic for multimorbid patients under polypharmacy. The aim of this study was to assess systematically the frequency and clinical relevance of incomplete medical data upon ED admission. Methods: The study was conducted in the neurological ED of a German tertiary hospital. The availability and accuracy of medical data of all neurological patients in the ED were assessed upon arrival. Treating ED physicians were asked about the acute care of the patients to clarify whether missing data resulted in delays or complications in the emergency treatment. Additionally, doctors responsible for the inpatient care of patients who were admitted to a ward via the ED were questioned about the course of the inpatient stay to monitor how initially missing data might have influenced the hospital stay. Results: Medical data of 27% of the 272 included patients were missing or incomplete upon admission in the ED. The ED physicians had to make additional phone calls to gather information in 57% of these cases (vs. 22% in patients with complete data, p < 0.0001). Delays between 5 and 240 min were documented due to initially missing data. Unnecessary diagnostic procedures (e.g., lumbar puncture) were performed in 5% of these patients, thus compromising patient safety. Even the inpatient stay was complicated by initially missing data, as doctors still had to spend time (between 10 and 180 min) to gain relevant information. Retrospectively, 5% of hospitalizations could have been avoided if all medical information had been available upon ED admission. Conclusions: Missing medical data caused complications and delays in acute as well as inpatient care of patients admitted to the neurological ED. This compromised patient safety and led to a waste of medical resources and valuable time of the responsible medical team. Therefore, a comprehensive, digital data management system is urgently needed to improve patient safety and facilitate efficient patient care in the ED and beyond. [ABSTRACT FROM AUTHOR]

Subsequent to the COVID-19 pandemic, waste management posed escalating challenges attributed to the imprudent disposal of medical waste, notably surgical masks. Hence, the present investigation was undertaken concomitantly to confront the dual concerns of mitigating environmental pollution and managing discarded face masks. The experimental methodology entailed the utilization of filtration chambers featuring surgical mask layers of distinct thicknesses, labeled as Treatment-0 (no mask layer), Treatment-1 (5 mm mask layer), Treatment-2 (10 mm mask layer), and Treatment-3 (15 mm mask layer), to eliminate pathogenic microorganisms from contaminated river water, Buriganga. At the end of the observation, Treatment-3 exhibited the most significant declination (88.15%) of the bacterial population. This treatment also removed most pathogens, including E. Coli (19.85%), total coliform (16.42%), and fecal coliform (12.02%). The findings underscore the significance of modern filtration systems and the efficient, ecologically viable recycling of medical waste, with a specific focus on surgical masks. [ABSTRACT FROM AUTHOR]

The rapidly growing applications of additive manufacturing (AM) are transforming the scenario of the medical industry for sustainably availing customized orthotic products. The adaptive interlinking attribute of 3D printing enables it to replicate the optimization results of a trauma-based anatomical problem, designed and solved with artificial intelligence (AI) for structural mechanics. In the present hybrid approach, the potential of simulation engineering has been used to solve the physics of a mallet trauma transforming existing geometry into an efficacious splint design capable of delivering improved recovery outcomes. The physical measurements have been precisely converted into a customized orthosis, by executing 3D scanning and printing over the optimized parameters availed by data analysis coupled with artificial intelligence of statistical tools. The topological simulation-predicted design was processed for creating the tailored 3D printed mallet splint with a prediction accuracy of 98.49%, availing 42.6% (weight 2.87 gm for 58.28% mass splint) lighter orthosis than the original (weight 5 gm for 100% mass splint) that provides effective ventilation with 149.19% greater heat dissipation. The noninvasive interaction for anthropometric data collection and appealing custom appliances fabricated with bio-sourced materials can trigger faster psychological and physiological healing in patients. The results recorded with an implemented hybrid approach can change the perspective of medical professionals for adopting the AM fused with simulation engineering, as a sustainable alternative to traditional services. The biocompatibility of 3D printed orthotic products facilitates the removal of the excess burden of medical waste and thus the applications of the adopted approach can be practiced for providing sustainable responses to other medical branches like podiatry, dentistry, orthopedics, rheumatology and neuropathy. [ABSTRACT FROM AUTHOR]

In this study, lanthanum oxide (La2O3) nanoparticles or lanthana were synthesized by the planetary ball milling method and then used as a filler for the preparation of the polypropylene (PP) based nanocomposites by solution mixing method. The PP used in the study was derived from the discarded saline bottles. The structural and the surface morphology of the synthesized lanthanum oxide nanoparticles were characterized by XRD, SEM and FTIR. The thermogravimetric analysis (TGA) study revealed that the thermal stability of the nano lanthana composites increased with the addition of the lanthanum oxide nanoparticles. The mechanical properties, such as Young's modulus and tensile strength, were also improved by the addition of the lanthanum oxide nanoparticles to the PP matrix. The composites also showed antibacterial activity against Escherichia coli bacteria. This approach not only mitigates medical plastic waste and environmental impact but also paves the way for versatile polymer nanocomposites with extensive industrial applications, especially in biomedical packaging. [ABSTRACT FROM AUTHOR]

This study investigates the efficacy of green betel leaf (Piper betle Linn) and lemongrass (Cymbopogon citratus) extracts as natural disinfectants in the medical waste recycling process in Indonesia. The research aims to provide a sustainable alternative to chemical disinfectants, such as chlorine, by optimizing the dosage and contact time for effective microbial reduction. The study focused on the disinfection of Bacillus subtilis and Staphylococcus as bioindicators, evaluating the impact of varying disinfectant concentrations on key environmental parameters, including pH, temperature, and total dissolved solids (TDS). The findings indicate that a 0.5% concentration with a 30-minute contact time is optimal for reducing Bacillus subtilis, while higher concentrations are required for effective Staphylococcus reduction. Additionally, the study reveals that higher disinfectant concentrations lower pH and increase TDS, posing potential challenges for wastewater management. These results highlight the potential of natural disinfectants to enhance the sustainability of medical waste management practices in Indonesia, though further research is needed to address the environmental and regulatory challenges associated with their use. [ABSTRACT FROM AUTHOR]

Background Pisum sativum: (PS) is a universal legume plant utilized for both human and animal consumption, particularly its seeds, known as green peas. The processing of PS in food industries and households produces a significant amount of waste that needs to be valorized. Methods: In this study, the metabolite profiles of the 70% ethanolic extracts of PS wastes, namely peels (PSP) and a combination of leaves and stems (PSLS), were investigated by liquid chromatography-electrospray ionization-quadrupole time-of-flight tandem mass spectrometry (LC-ESI-QTOF-MS/MS) followed by molecular networking. Results: Different classes of metabolites were identified, being flavonoids and their derivatives, along with phenolic acids, the most abundant categories. Additionally, a comprehensive network pharmacology strategy was applied to elucidate potentially active metabolites, key targets, and the pathways involved in cytotoxic activity against breast cancer. This cytotoxic activity was investigated in MCF-7 and MCF-10a cell lines. Results revealed that PSLS extract exhibited a potent cytotoxic activity with a good selectivity index (IC50 = 17.67 and selectivity index of 3.51), compared to the reference drug doxorubicin (IC50 = 2.69 µg/mL and selectivity index of 5.28). Whereas PSP extract appeared to be less potent and selective (IC50 = 32.92 µg/mL and selectivity index of 1.62). A similar performance was also observed for several polyphenolics isolated from the PSLS extract, including methyl cis p-coumarate, trans p-coumaric acid, and liquiritigenin/ 7-methyl liquiritigenin mixture. Methyl cis p-coumarate showed the most potent cytotoxic activity against MCF-7 cell line and the highest selectivity (IC50 = 1.18 µg/mL (6.91 µM) and selectivity index of 27.42). The network pharmacology study revealed that the isolated compounds could interact with several breast cancer-associated protein targets including carbonic anhydrases 1, 2, 4, 9, and 12, as well as aldo-keto reductase family 1 member B1, adenosine A3 receptor, protein tyrosine phosphatase non-receptor type 1, and estrogen receptor 2. Conclusion: The uncovered therapeutic potential of PSLS and its metabolite constituents pave the way for an efficient and mindful PS waste valorization, calling for further in-vitro and in-vivo research. [ABSTRACT FROM AUTHOR]

Proper hospital waste management poses important concerns due to the risk capacity of hospital waste to health and the environment. Healthcare management approaches have changed in recent years, motivated by the desire to minimize the environmental impact. The review aims to examine the current HCW and considers the local challenges associated with establishing a circular economy (CE) to improve hospital waste management regarding training along Plan, Do, Check, and Act (PDCA). The study found that mean medical and general waste segregation rates in public hospitals were 50.15 and 49.85, respectively. On average, 3.6 kg of waste was generated per bed per day. Analysis revealed a significant correlation between total waste and infectious waste with the number of occupied beds in the hospital (p < 0.05). Updating national laws by the CE approach is necessary. Our insights into circular hospital waste urge establishing a green management team, new training methods, and continuous supervision. Using PDCA to enhance waste segregation, training, and other aspects of hospital waste management is vital. [ABSTRACT FROM AUTHOR]

Medical waste management is a crucial issue due to its potential health risks to humans and harm to the environment. The World Health Organization (WHO) advises separating medical waste into seven groups based on its type. However, despite the implementation of color-coded bin bags, cases of missegregation still occur frequently, leading to injuries and spreading diseases. Infectious waste such as sharps, human tissue, and body parts are often found mixed in waste bins, posing a severe threat to waste employees. To address this issue, this paper proposes exploring the potential of digitalization in waste segregation. The literature on current segregation methods and technology applications is analysed and compared, and a framework for utilizing barcode tagging and scanning to ensure waste is correctly categorized is presented. The barcodes and scanner will be connected through a monitoring system, which can notify waste generators and collectors of misplacing or mixed waste. This digitalization system is expected to serve as a monitoring agent for segregating waste before it is collected from any health facilities. Additionally, the exchanged data from waste generator bins can inform collectors and other waste stakeholders about the waste's condition, potentially opening up opportunities for recycling companies to purchase used plastics or metals from hospital wastes. By implementing digitalization in medical waste management, waste segregation can improve, reduce the spread of diseases and injuries, and promote the recycling of hospital waste materials. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has led to a surge in medical waste generation, posing hazards to both the environment and global health. The impacts of the COVID-19 pandemic's medical waste hazard may persist long after the pandemic itself subsides. Improper disposal of medical waste can contaminate environment, posing risks to ecosystems and public health. Discarded medical rubber gloves, for example, can become a source of infection, improper disposal of these gloves can escalate the spread of infectious diseases and increase the risk of transmission of the virus to the general public. This study proposes an innovative and sustainable method to reinforce cement mortar by adding recycled glove rubber as an additive to cement mortar to increase its resistance to impact loads. This study conducted uniaxial compression tests, separating hopkinson pressure bar (SHPB) experiments and SEM observations to evaluate the quasi-static compressive strength and dynamic stress of recycled rubber fiber mortar (RRFM) with varying recycled rubber fiber (RRF) contents (0, 1%, 2%, 3%). Strain curves, dynamic increase factor (DIF), energy absorption rules, failure modes, and microstructure of RRFM mixtures. The experimental results demonstrate that with the addition of RRF, the dynamic stress-strain curve flattens and the peak strain gradually increases. The RRFM sample shows stronger toughness. In comparison to regular cement mortar (NM), RRFM has a higher DIF and specific absorbed energy, a faster increase in dynamic compressive strength, and the ability to absorb more energy per unit volume. Under the same impact load, RRFM has fewer and smaller cracks than NM. Scanning electron microscopy (SEM) testing also observed that RRF formed a strong connection pattern with the cement mortar matrix. [ABSTRACT FROM AUTHOR]

Taiwan has been an active participant in waste recycling for a long period of time due to the need for resource sustainability. The country believes it can one day eventually achieve the goal of zero waste through the effective use of strategies such as source reduction, resource recovery, reuse, and recycling. Despite Taiwan's long‐standing commitment to waste recycling for purposes of resource sustainability, achieving the goal of zero waste remains an immense challenge. Therefore, putting into effect the previously mentioned strategies will obviously be necessary in order to realize this goal. However, the effective implementation of these strategies requires both comprehensive planning and coordination, particularly in large medical institutions. Here, we have aimed to promote waste reduction throughout the entire hospital system in Taiwan using 3 strategies: (1) standardizing the colors of garbage bags, marking patterns of waste, and reviewing and establishing an internal audit mechanism on a regular basis; (2) the systematic monitoring of individual departments with regard to on waste consumption, brands, and materials while linking departments to the procurement source management team. In addition, any related hardware has been upgraded, precisely controlled, and automatically uploaded to the cloud system for an improved intelligent management system. In addition, the Department of Nutrition has adjusted the handling of ingredients and consumption patterns of hospital employees in order to reduce food waste; and (3) with regard to the disposal of medical waste, medical centers will be consolidating and advancing the knowledge and ability of all hospital personnel through education and training programs established for them. After the implementation of this program to promote awareness, the ratio of biological waste percentage in regard to total hospital waste dropped from 37.3% in 2018 to 33.6% in 2022, with a 49% decrease being seen in food waste, and a 99.32% increase being realized in green designated procurement items. Such an efficient management of medical waste has no doubt been extremely beneficial to the hospital. [ABSTRACT FROM AUTHOR]

The escalating generation of household medical waste, a byproduct of industrialization and global population growth, has rendered its transportation and logistics management a critical societal concern. This study delves into the optimization of routes for vehicles within the household medical waste logistics network, a response to the imperative of managing this waste effectively. The potential for environmental and public health hazards due to improper waste disposal is acknowledged, prompting the incorporation of contamination risk, influenced by transport duration, waste volume, and wind velocity, into the analysis. To enhance the realism of the simulation, traffic congestion is integrated into the vehicle speed function, reflecting the urban roads' variability. Subsequently, a Bi-objective mixed-integer programming model is formulated to concurrently minimize total operational costs and environmental pollution risks. The complexity inherent in the optimization problem has motivated the development of the Adaptive Hybrid Artificial Fish Swarming Algorithm with Non-Dominated Sorting (AH-NSAFSA). This algorithm employs a sophisticated approach, amalgamating congestion distance and individual ranking to discern optimal solutions from the population. It incorporates a decay function to facilitate an adaptive iterative process, enhancing the algorithm's convergence properties. Furthermore, it leverages the concept of crossover-induced elimination to preserve the genetic diversity and overall robustness of the solution set. The empirical evaluation of AH-NSAFSA is conducted using a test set derived from the Solomon dataset, demonstrating the algorithm's capability to generate feasible non-dominated solutions for household medical waste recycling path planning. Comparative analysis with the Non-dominated Sorted Artificial Fish Swarm Algorithm (NSAFSA) and Non-dominated Sorted Genetic Algorithm II (NSGA-II) across metrics such as MID, SM, NOS, and CT reveals that AH-NSAFSA excels in MID, SM, and NOS, and surpasses NSAFSA in CT, albeit slightly underperforming relative to NSGA-II. The study's holistic approach to waste recycling route planning, which integrates cost-effectiveness with pollution risk and traffic congestion considerations, offers substantial support for enterprises in formulating sustainable green development strategies. AH-NSAFSA offers an eco-efficient, holistic approach to medical waste recycling, advancing sustainable management practices. [ABSTRACT FROM AUTHOR]

This article examines three debates over the nature of human specimens: anatomical dissection in Victorian Britain the question of ownership over Henrietta Lacks's cells and recent debates over how to treat remnants of abortion. These cases reveal that specimens are deeply connected to human persons and should be considered with a particular kind of care. The author uses Andrew Solomon's concept of horizontal kinship to support reframing medical waste as "relics"—objects of veneration interpreted as revealing truth about the human experience. Envisioning medical waste as relics allows us to wonder at the ability of the body to provide transformative knowledge which leads to practices of appreciation to honor the sacrifices of the body. [ABSTRACT FROM AUTHOR]

Ageing is associated with an increased risk of adverse drug reactions. This calls for great care and diligent follow up when prescribing medication to older patients. Yet, this is seldom the case and the proportion of older people taking five or more medications has quadrupled from 12% to 49% in the last 20 years. Certain medications are riskier than others. Those with anticholinergic effects are of particular concern. Adverse effects of anticholinergics include dry mouth, nausea, dizziness, fatigue, vomiting, constipation, abdominal pain, urinary retention, blurred vision, tachycardia and neurologic impairment, such as confusion and agitation. Anticholinergic medication can cause daytime drowsiness and cognitive decline, while increasing the risk of fall and can lead to increased mortality. Although anticholinergic medication should be avoided in older people whenever possible, their use has almost doubled in the last 20 years, and those who are most vulnerable to its adverse effects had the greatest increase in use. This article examines why older people are at increased risk of adverse drug reactions and how medication review can enable older persons to take medications regularly, improve quality of life and minimise medication waste. [ABSTRACT FROM AUTHOR]

Background: Surgical care in the operating room (OR) contributes one-third of the greenhouse gas (GHG) emissions in healthcare. The European Association of Endoscopic Surgery (EAES) and the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) initiated a joint Task Force to promote sustainability within minimally invasive gastrointestinal surgery. Methods: A scoping review was conducted by searching MEDLINE via Ovid, Embase via Elsevier, Cochrane Central Register of Controlled Trials, and Scopus on August 25th, 2023 to identify articles reporting on the impact of gastrointestinal surgical care on the environment. The objectives were to establish the terminology, outcome measures, and scope associated with sustainable surgical practice. Quantitative data were summarized using descriptive statistics. Results: We screened 22,439 articles to identify 85 articles relevant to anesthesia, general surgical practice, and gastrointestinal surgery. There were 58/85 (68.2%) cohort studies and 12/85 (14.1%) Life Cycle Assessment (LCA) studies. The most commonly measured outcomes were kilograms of carbon dioxide equivalents (kg CO2eq), cost of resource consumption in US dollars or euros, surgical waste in kg, water consumption in liters, and energy consumption in kilowatt-hours. Surgical waste production and the use of anesthetic gases were among the largest contributors to the climate impact of surgical practice. Educational initiatives to educate surgical staff on the climate impact of surgery, recycling programs, and strategies to restrict the use of noxious anesthetic gases had the highest impact in reducing the carbon footprint of surgical care. Establishing green teams with multidisciplinary champions is an effective strategy to initiate a sustainability program in gastrointestinal surgery. Conclusion: This review establishes standard terminology and outcome measures used to define the environmental footprint of surgical practices. Impactful initiatives to achieve sustainability in surgical practice will require education and multidisciplinary collaborations among key stakeholders including surgeons, researchers, operating room staff, hospital managers, industry partners, and policymakers. [ABSTRACT FROM AUTHOR]

Background: Surgical care significantly contributes to healthcare-associated greenhouse gas emissions (GHG). Surgeon attitudes about mitigation of the impact of surgical practice on environmental sustainability remains poorly understood. To better understand surgeon perspectives globally, the Society of American Gastrointestinal and Endoscopic Surgeons and the European Association for Endoscopic Surgery established a joint Sustainability in Surgical Practice (SSP) Task Force and distributed a survey on sustainability. Methods: Our survey asked about (1) surgeon attitudes toward sustainability, (2) ability to estimate the carbon footprint of surgical procedures and supplies, (3) concerns about the negative impacts of sustainable interventions, (4) willingness to change specific practices, and (5) preferred educational topics and modalities. Questions were primarily written in Likert-scale format. A clustering analysis was performed to determine whether survey respondents could be grouped into distinct subsets to inform future outreach and education efforts. Results: We received 1024 responses, predominantly from North America and Europe. The study revealed that while 63% of respondents were motivated to enhance the sustainability of their practice, less than 10% could accurately estimate the carbon footprint of surgical activities. Most were not concerned that sustainability efforts would negatively impact their practice and showed readiness to adopt proposed sustainable practices. Online webinars and modules were the preferred educational methods. A clustering analysis identified a group particularly concerned yet willing to adopt sustainable changes. Conclusion: Surgeons believe that operating room waste is a critical issue and are willing to change practice to improve it. However, there exists a gap in understanding the environmental impact of surgical procedures and supplies, and a sizable minority have some degree of concern about potential adverse consequences of implementing sustainable policies. This study uniquely provides an international, multidisciplinary snapshot of surgeons' attitudes, knowledge, concerns, willingness, and preferred educational modalities related to mitigating the environmental impact of surgical practice. [ABSTRACT FROM AUTHOR]

The bottom ash produced during incineration contains toxic heavy metals that can persist for a long time in the environment and accumulate in the food chain; when indiscriminately disposed of, it can adversely affect public health. The study aimed at assessing the level of heavy metals in the bottom ashes produced during the incineration of sharp medical waste. Bottom ash samples were collected from the ash pit of the incinerator twice a month for four months (two months in the rainy and two months in the dry season) in triplicates. Five grams of the sieved samples were analyzed for cadmium (Cd), chromium (Cr), Nickel (Ni), iron (Fe), lead (Pb), Copper (Cu), and zinc (Zn) using atomic absorption spectrophotometer. The mean concentrations of these heavy metals during the study period in decreasing order were Fe (18,504.66) > Zn (16,292.11) > Cr (374.47) > Pb (179.78) > Cu (128.91) > Cd (1.28) > Ni (0.50) mg/kg. The concentrations of the assessed heavy metals in the bottom ash samples obtained were compared with notable international guidelines, and it was deduced that the concentrations of all the heavy metals were above the acceptable limits except for Nickel, whose concentration was below the limit set for it. [ABSTRACT FROM AUTHOR]

Purpose Despite national recommendations to standardize infusion concentrations, there is minimal guidance on institution-specific strategies and outcomes related to epidural infusion concentration standardization and optimization. The purpose of this project is to identify the optimal compounded preparation for use in select adult epidural infusions and assess the impact on drug and fluid utilization and cost savings if the designated preparation is adopted. Methods A previously validated tool, the VERB (vial, exchange, rate, and bag) analysis, was applied to epidural infusion pump administration data to identify preparations optimized for efficient supply and resource utilization at a large academic medical center. Results Weighing all components of the VERB analysis, the preferred preparation of hydromorphone and bupivacaine for the hospital site was hydromorphone (10 µg/mL) and bupivacaine (0.125%) in 50 mL of 0.9% sodium chloride injection (2,500 µg of hydromorphone per epidural). The preferred preparation of fentanyl and bupivacaine was fentanyl (2 µg/mL) and bupivacaine (0.0625%) in 50 mL of 0.9% sodium chloride injection (100 µg of fentanyl per epidural). Both recommendations are different from the currently utilized preparations at the study site. Conclusion Analyzing historic drug administration data using the novel 4-step VERB analysis identified optimized drug preparations and fluid bag sizes for the most-prescribed epidural drug combinations at the hospital study site. [ABSTRACT FROM AUTHOR]

Background: The balance between reducing patient wait time and mitigating waste of parenteral products has not been well described in literature. Objective: Evaluate the patient wait times and cost-effectiveness of employing a premix versus an on-demand workflow model for compounding parenteral admixtures in a hematology/oncology infusion setting. Methods: This single center, retrospective cost analysis compiled manually documented monthly waste reports and estimated drug pricing for the institution to calculate the cost of waste during both premix and on-demand compounding workflows. Time to administration was audited for one week with both models. Results: Over a period of 28.5 months following the premix model, 564 products were documented as wasted ($1,196,014.01 in estimated drug purchasing cost). Over a period of 3 months following the on-demand model, 12 products were wasted ($34,823.98 in estimated drug purchasing cost). Switching models reduced the monthly average number of wasted products from 20 to 4 per month; the average cost of waste was reduced from $41,965.40 to $11,607.99 per month (P <.0001). Overall patient wait time from clearance until administration, excluding any recommended wait times after premedication administration (if applicable), was similar in both models: an average of 38.26 minutes in the premix model and 40.97 minutes in the on-demand model. Conclusion: Premixing parenteral admixtures was not cost effective at our institution. After resuming an on-demand compounding model, the monthly cost of waste (based on drug pricing alone) was reduced by over 70%. The wait time from clearance to treatment administration was similar in both models. [ABSTRACT FROM AUTHOR]

In the present work, medical waste ash was used as an aluminosilicate precursor to produce a geopolymer binder with stabilised heavy metals. The ash was initially calcined at a temperature of 800 °C for two hours to reduce the organic content. Calcined kaolin and medical waste ash were used as precursors to produce the geopolymer binder and sodium silicate and calcium oxides were used as alkaline activators. The effect of curing temperature (23, 60, and 100 °C) and the calcium oxide addition (0, 5, and 10%) on the geopolymer properties were evaluated. Eighteen geopolymer samples were prepared and evaluated for immobilizing heavy metals through the Toxicity Characteristic Leaching Procedure (TCLP). When compared to raw materials, TCLP results indicated that geopolymerization can significantly reduce the concentration of heavy metals in the medical waste ash leachate. The metal fixation percentages of the geopolymers ranged from 70 to 100%. The sequential extraction test results showed that geopolymerization (stabilization/solidification) is very beneficial in reducing the bioavailable fraction in the solid waste and maximizing the difficulty of fraction extraction. [ABSTRACT FROM AUTHOR]

Purpose: The study aims to identify and address the key challenges that are faced during the implementation of Circular Economy (CE) for sustainable healthcare. Design/methodology/approach: This scoping review follows Levac et al.'s (2010) methodological framework, enhanced by Pham (2014) and Tricco (2016), to identify and address relevant literature on challenges and solutions of implementing CE in healthcare. A comprehensive search of SCOPUS, EBSCO, ProQuest, and Web of Science yielded 112 articles (2010 onwards), with 73 meeting inclusion criteria focused on CE challenges and solutions in healthcare. The extracted data were synthesized using a narrative approach to identify key themes and research gaps. Findings: The study finds key challenges in implementing CE principles in healthcare, including resource depletion, medical waste, energy consumption, emissions, and healthcare inequity. Healthcare's high use of resources and energy results in environmental threats and costs, while significant medical waste contributes to pollution. CE strategies can enhance efficiency, reduce waste, and lower emissions. Overcoming these challenges requires improving resource management, promoting recycling, and ensuring equitable access to sustainable healthcare. Research limitations/implications: Findings may not be universally applicable due to regional variations in healthcare systems and regulations. Rapid advancements in CE and healthcare technologies may have emerged since the review, affecting the relevance. Practical challenges like regulatory hurdles and financial constraints were identified but not exhaustively explored. Practical implications: By identifying the main challenges in the implementation of CE principles in healthcare, the study provides valuable guidance for policymakers to develop targeted policies addressing resource depletion, waste management, energy consumption and emissions, and equitable access to sustainable healthcare. For healthcare practitioners, the study offers actionable insights for implementing solutions like recycling programs, energy-saving measures, and sustainable procurement practices within their facilities. Social implications: Promoting CE practices can reduce pollution, minimize healthcare facilities' environmental footprint, and ensure equitable access to sustainable healthcare. Originality/value. The originality of this study lies in its comprehensive examination of challenges and solutions for implementing CE principles in healthcare. Focusing on the interconnectedness of sustainability, public health, and social equity, this scoping review offers actionable strategies for promoting sustainability in healthcare systems. Category of the paper: Scoping Review. [ABSTRACT FROM AUTHOR]

The rapid growth in Biomedical Waste (BMW) generation poses significant challenges to effective BMW management, impacting the health and safety of healthcare and sanitation workers, patients, and the public. Segregating BMW at the source is critical to the BMW management system. However, in developing countries like India, less than half of the BMW is segregated at the source due to logistical challenges associated with manual segregation. This study addresses these challenges by developing a deep learning model for automated BMW segregation based on the Indian Government's Biomedical Waste Management Rules, 2016. To achieve this, the BMW-Seg-India dataset was created with images collected from a multi-specialty hospital in India and other publicly available datasets and organized into four classes: yellow, red, white, and blue, in line with the guidelines. A novel deep-learning model, BMWNet52, employing a modified ResNet50 architecture, was trained with transfer learning on the dataset. The model achieved an accuracy of 97.99% in classifying the four categories, demonstrating that this deep-learning classifier is an effective solution for automated BMW segregation. The findings could lead to a fully autonomous BMW management system, integrating automated segregation and disposal, minimizing exposure to hazardous waste, and enhancing efficiency worldwide. [ABSTRACT FROM AUTHOR]

Military burn pits, used for waste disposal in combat zones, involve the open-air burning of waste materials, including plastics, metals, chemicals, and medical waste. The pits release a complex mixture of occupational toxic substances, including particulate matter (PM), volatile organic compounds (VOCs), heavy metals, dioxins, and polycyclic aromatic hydrocarbons (PAHs). Air pollution significantly impacts brain health through mechanisms involving neuroinflammation. Pollutants penetrate the respiratory system, enter the bloodstream, and cross the blood–brain barrier (BBB), triggering inflammatory responses in the central nervous system (CNS). Chronic environmental exposures result in sustained inflammation, oxidative stress, and neuronal damage, contributing to neurodegenerative diseases and cognitive impairment. Veterans exposed to burn pit toxins are particularly at risk, reporting higher rates of respiratory issues, neurological conditions, cognitive impairments, and mental health disorders. Studies demonstrate that Veterans exposed to these toxins have higher rates of neuroinflammatory markers, accelerated cognitive decline, and increased risks of neurodegenerative diseases. This narrative review synthesizes the research linking airborne pollutants such as PM, VOCs, and heavy metals to neuroinflammatory processes and cognitive effects. There is a need for targeted interventions to mitigate the harmful and escalating effects of environmental air pollution exposures on the CNS, improving public health outcomes for vulnerable populations, especially for Veterans exposed to military burn pit toxins. [ABSTRACT FROM AUTHOR]

• The ash melting temperature decreased on the influence of Na2O. • An appropriate ratio of MBA and MFA can effectively reduce the Cr leaching level. • The stabilization of heavy metals was enhanced when vitreous content exceeded 97.7%. • The solidification effect on Mn and Zn was readily apparent. Medical waste incineration ash (MWIA) has significant concentrations of heavy metals, dioxins, and chlorine that, if handled incorrectly, might cause permanent damage to the environment and humans. The low content of calcium (Ca), silicon (Si), and aluminum (Al) is a brand-new challenge for the melting technique of MWIA. This work added coal fly ash (CFA) to explore the effect of melting on the detoxication treatment of MWIA. It was found that the produced vitrification product has a high vitreous content (98.61%) and a low potential ecological risk, with an initial ash solidification rate of 67.38%. By quantitatively assessing the morphological distribution features of heavy metals in ashes before melting and molten products, the stabilization and solidification rules of heavy metals during the melting process were investigated. This work ascertained the feasibility of co-vitrification of MWIA and CFA. In addition, the high-temperature melting and vitrification accelerated the detoxification of MWIA and the solidification of heavy metals. [ABSTRACT FROM AUTHOR]

• The effect of temperature on plasma gasification of CPMW is explored experimentally. • A temperature of 1800 °C provides the optimum performance for air-CPMW gasification. • The volume fraction of H 2 and CO increases with the increased reactor temperature. Plasma gasification melting (PGM) provides reliable disposal of toxic medical waste with a low heating value, which is capable of converting waste into energy. This study investigates the performance of experiments on plasma gasification for the treatment of chemical-pharmaceutical medical waste (CPMW) with an air medium. A comparative analysis is performed for gasification characteristics at three reactor temperatures (1000, 1400, and 1800 °C). Moreover, a thermodynamic equilibrium model is developed to assess performance features such as syngas yield, high heating value, and cold gas efficiency in the gasification temperature range of 1000–1800 °C. A comparison of the experiment and computational outcomes shows a good agreement. The results show that the quality of syngas and heating value is improved by increasing the temperature of the plasma gasifier so that at 1800 °C, H 2 , CO, and higher heating value (HHV) are obtained as 41 %, 37 %, and 10 MJ/Nm3, respectively. The obtained syngas is a clean fuel with low sulfur-containing and nitrogen-containing. The experimental results provide an extensive comprehension of CPMW gasification in a plasma reactor and consider a possibility for hydrogen and energy production. [ABSTRACT FROM AUTHOR]

Traditional healthcare delivery models face mounting pressure from rising costs, increasing demand, and a growing environmental footprint. Hospital at Home (HaH) has been proposed as a potential solution, offering care at home through in-person, virtual, or hybrid approaches. Despite focus on expanding HaH provision and capacity, research has primarily explored patient care outcomes, patient satisfaction economic costs with a key gap in its environmental impact. By reducing this evidence gap, HaH may be better placed as a positive enabler in delivering healthier planet and population. This article explores the environmental opportunities and challenges associated with HaH compared to traditional hospital care and reinforces the case for further research to comprehensively quantify the environmental impact including any co-benefits. Our aim for this article is to spark conversation, and begin to help prioritise future research and analysis. [ABSTRACT FROM AUTHOR]

Traditional waste incineration generates a large amount of exhaust gas, resulting in adverse environmental impacts. Therefore, we developed an organic and intelligent photochemical processing system that utilizes high-energy lasers for incineration, thereby reducing the production of exhaust gas. A large-scale laser machine was set up, incorporating low-cost 2D Light Detection and Ranging (LiDAR) technology for system sensing, which performs angle range and threshold filtering, as well as multispectral laser allocation, integrated with the laser ablation machine system. After testing, the error was <5 mm (<8%), achieving precise object scanning and ranging and solving the problem of manual laser positioning. Experimental results showed that CO2 lasers can effectively process organic materials and medical waste of different sizes. This innovative research will have profound implications for the future development of environmental protection and incineration technologies. In the future, it has widespread application prospects in areas such as pet waste disposal and medical waste treatment. [ABSTRACT FROM AUTHOR]

The use of plastic products or components in medical equipment and supplies results in challenges in terms of environmental sustainability and waste management for disposable, non-recyclable, and non-biodegradable materials. Medical plastic waste includes items ranging from syringes, tubing, intravenous (IV) bags, packaging, and more. Developing biodegradable replacements to petroleum-based plastics in medical equipment has not yet become an urgent priority, but it is an important endeavor. Examining alternatives involves several key themes, including material selection, testing, validation, and regulatory approval. To date, research includes studies on biodegradable polymers, composite materials, surface modifications, bacterial cellulose, three-dimensional (3D) printing with biodegradable materials, clinical trials and testing, collaboration with industry, regulatory considerations, sustainable packaging for medical devices, and life cycle analysis. The incorporation of bio-based and biodegradable plastics in the healthcare industry holds immense potential for reducing the environmental impact of medical plastic waste. The literature suggests that researchers and industry professionals are actively working towards finding sustainable alternatives that meet the stringent requirements of the medical industry. This paper reviews the efforts made so far to develop biodegradable and sustainable alternatives to plastic in medical equipment using a meta-analysis of resources, which include relevant papers published in English until June 2024. A total of 116 documents were found and screened by three reviewers for relevance. The literature reviewed indicated that various medical uses require plastics due to their unique properties, such as having strength and flexibility; being lightweight; and being able to prevent bacterial contamination. Among the alternatives, polycaprolactone (PCL), polylactic-co-glycolic acid (PLGA), starch-based acid, and polybutyric acid (PBS) have demonstrated favourable outcomes in terms of biocompatibility, safety, and efficacy. Additionally, a set of approaches to overcome these barriers and strategies is discussed alongside potential future solutions. This review aims to catalyze discussions and actions toward a more environmentally sustainable future in the medical industry by providing a comprehensive analysis of the current state, challenges, and prospects of this domain. [ABSTRACT FROM AUTHOR]

This research explored the life cycle analysis and environmental cost-benefit assessment of converting ash waste from hospital medical waste incineration into environmentally safe paving block raw materials. The growing concerns about medical waste disposal and its environmental impact necessitate innovative solutions for sustainable waste management. This research aimed to evaluate the feasibility and environmental implications of reusing hospital waste into raw materials for paving block mixtures. This research, a comprehensive life cycle analysis, examined the environmental impacts of medical waste collection for the production and use of paving blocks. Additionally, we conducted an environmental cost-benefit assessment to ascertain the economic feasibility and potential environmental impact forecasts of this recycling approach. The research results show that converting hospital medical waste ash into mixed raw materials for paving blocks not only immobilizes heavy metals but also provides a sustainable alternative for non-building materials. These findings highlight the potential for significant environmental and economic benefits, making this approach a promising strategy for waste management and sustainable construction practices. The cost of preventing environmental damage (eco-cost) in the process of converting ash from the incineration of medical waste into a mixture of raw materials for paving blocks is IDR 600,180.9 per cycle. [ABSTRACT FROM AUTHOR]

Hemodialysis is an important part of nosocomial infection prevention and control (IPC). This study aimed to identify the key potential risk areas and failure modes in hemodialysis rooms in hospitals and put forward a series of improvement measures to prevent and control the spread of the coronavirus disease 2019 (COVID‐19). Hemodialysis patients are highly susceptible to COVID‐19 and usually have a high incidence of severe illness and mortality after infection with COVID‐19. Therefore, IPC in hemodialysis patients is of crucial strategic significance. Based on 30 domain experts' interviews and careful analysis of prevention and control documents, we constructed a comprehensive failure system for a model that identifies the potential risks for nosocomial COVID‐19 infection in the hemodialysis room. Subsequently, a thorough risk assessment of the potential failure factors identified in our model was conducted. The failure key factors corresponding to the human element in medical waste (garbage) disposal (C2) are verified to be the highest risk factors. They are as follows: The cleaning staff did not dispose of different types of medical waste (garbage) (C21), did not wear masks according to the regulations (C22), and lacked knowledge and norms of nosocomial IPC (C23). This study provides valuable insights for hospital decision‐makers on the potential failure factors related to COVID‐19 infections in hemodialysis rooms. By working with hospital infection specialists, the suggested improvement measures can help reduce the risk of virus exposure among hospital medical staff, patients, and cleaning staff. [ABSTRACT FROM AUTHOR]

Household medical waste is often improperly disposed of in several countries, despite the presence of a collection mechanism. This study attempts to identify the challenges of medical waste collection systems, focusing on the regulatory instruments and the stakeholders involved in this process in Brazil, Chile, and Colombia. A descriptive analysis was conducted to identify the differences between these countries. The results reveal that, in general, only 7 out of the 20 regulatory instruments for solid waste are applied in the household medical waste collection process, focusing on the direct stakeholders in the human medicines market, from manufacturers to consumers. The main challenges identified are incorporating veterinary medicines, defining roles for all stakeholders involved, such as healthcare providers and health teaching institutions, and expanding the use of regulatory instruments. These findings support the use of legislation to reduce the stakeholder contributions gap for the collection of household medical waste. [ABSTRACT FROM AUTHOR]

Value-based healthcare payment models are an alternative insurance payment system that compensates healthcare providers based on their patients' outcomes rather than the individual services healthcare workers provide. This shift from the current fee-for-service model that predominates our medical system has received renewed popularity and attention within organized medicine such as the American Medical Association. Advocates believe that this new payment model will address many of the unsolved issues in healthcare such as medical waste and unsustainable healthcare costs. In practice, however, this model is plagued with a myriad of unresolved issues of its own. In this commentary, we outline these issues and suggest that the intentions of those advocating for value-based payment models are either misguided or disingenuous. We then offer solutions that preserve our current fee-for-service model while making necessary changes that will benefit both physicians and patients nationwide. [ABSTRACT FROM AUTHOR]

Wearing face masks is the best way to stop the spread of respiratory infections. However, if masks are not sterilized, changing them too frequently can actually increase the risk of cross‐contamination. Herein, the construction of an antipathogen photocatalytic mask with carbon vacancy‐modified carbon nitride nanosheets (g‐C3N4‐VC Ns) coated on the non‐woven fabrics of the out layer of the mask, offering effective and long‐term protection against damaging pathogens when exposed to light is reported. The introduced carbon vacancies are found capable of creating energy‐disordered sites and inducing energetic electric force to overcome the Coulomb interactions between electron‐hole pairs, thus promoting the electron‐hole separation to achieve a high generation of reactive oxygen species (ROS). Thanks to its high activity in generating ROS upon exposure to light, the as‐prepared photocatalytic mask shows high pathogen sterilization performance. This, in turn, prolongs the mask's protective lifetime, decreases the need for regular replacement, and decreases medical waste production. The work demonstrated here opens new viewpoints in designing pathogens biocidal protective devices for health protection, offering significant promise in specific environment self‐protection. [ABSTRACT FROM AUTHOR]

Background Aim Study Design Results Conclusions Relevance to Clinical Practice In intensive care units, it is noticeable that there is intensive use of resources in the treatment and care process, leading to a significant amount of waste generation. In addition, the demand for intensive care, increasing life expectancy and surgical interventions, complex comorbidities and ecological crisis make it necessary to make critical care more sustainable.To explore the perspectives of nurses working in surgical intensive care units regarding responsible medical waste management, energy and medication consumption.This qualitative descriptive study was conducted in surgical intensive care units of a university hospital in Turkey in November 2023. Twenty‐three nurses filled in an introductory form and participated in a semi‐structured interview. Data were analysed using inductive content analysis.Three main themes were determined: environmentally sustainable intensive care, prevention of waste in intensive care; responsible consumption and recycling; suggestions for institutional and individual behavioural change regarding environmental sustainability.The majority of nurses lack knowledge about sustainable development goals. However, in the intensive care unit, they provided effective and creative solutions for medical waste management, energy and medication consumption and individual and institutional behavioural change regarding environmental sustainability.Sustainability strategies should be created in institutions to ensure responsible medical waste management, energy and medicine consumption and reduce carbon footprint. In accordance with this purpose, ‘Green teams’ including unit‐based doctors, nurses and paramedics should be established. Training should be provided and awareness should be raised to reduce energy use resulting from heating, lighting, ventilation and air conditioning. [ABSTRACT FROM AUTHOR]

Concerns about the increasing consumption of medicines have been raised due to their contribution to waste pollution and environmental impacts. However, limited research addresses the profile and disposal practices of household medicines, particularly in Latin America. Therefore, this study analyzes the consumption, waste, and disposal of medicines within households in the commune of La Serena, Chile. Primary data were gathered through a semi-structured survey administered directly to a random sample of 430 households. The results indicate that women play a central role in managing medicines within households, with four therapeutic groups being most frequently used in medicines and generating waste: anti-inflammatory/analgesics, antihypertensives, lowering cholesterol, and antidiabetics. Ninety-six% of respondents were unaware of the collection points for this waste, and they disposed of it mainly in household garbage (78%) and sewage (13%). However, over 70% of them considered storing or disposing of medicines in household garbage or sewage to be "dangerous or very dangerous." Furthermore, 97% expressed support for collection campaigns. These results indicate the need for public policies to establish collection points for this waste and to inform consumers about the responsible use and proper disposal of medicines, particularly for women and patients with chronic illnesses. [ABSTRACT FROM AUTHOR]

Objective: This study aims to identify the obstacles to recycling and environmental sustainability habits in a university hospital's operating room (OR) environment in Turkey and lay the groundwork for potential solutions. Methods: A questionnaire was used to measure current views among the 140 OR staff members aged 20-54 years. The survey assessed awareness and behaviors of recycling at home and in the OR, as well as awareness of environmentally safe anaesthesia practices. Results: Half of the participants believed that ORs significantly affected their carbon footprint, and most agreed that these environmental effects could be reduced. The primary barriers to recycling were inadequate knowledge, negative staff attitudes and insufficient services. Notably, 76% of participants paid attention to segregating OR waste, yet many lacked formal education about the environmental impact of their practices. Approximately 89% agreed that the environmental effects of ORs could be further reduced, with education being a critical need. Conclusion: The healthcare sector's contribution to carbon emissions and waste production is significant, especially in ORs. The lack of education regarding ecological implications is concerning. Implementing standardized training programs and enhancing recycling services can substantially reduce the environmental impact of ORs, highlighting the need for a more sustainable healthcare system. [ABSTRACT FROM AUTHOR]

The prevalent use of unsustainable polymers in current X‐ray scintillators poses a significant environmental concern. The advancement of biodegradable X‐ray scintillators holds promise in mitigating escalating environmental issues tied to electronic or medical waste and carbon footprints. Herein, a biodegradable and flexible X‐ray scintillation film is presented employing lead‐free 0D Cs3Cu2I5 perovskite nanoparticles integrated into densified‐delignified wood (Cs3Cu2I5@D‐Wood). The Cs3Cu2I5@D‐Wood film demonstrates precise and detailed X‐ray imaging capabilities, achieving a high spatial resolution of 10 line pairs per millimeter (lp·mm−1). To minimize the environmental impact associated with disposal, metal and halide ions (e.g., Cs+, Cu+, I−) from Cs3Cu2I5@D‐Wood can be easily retrieved by a simple solvent extraction process. The approach showcases the potential of biodegradable wood‐based X‐ray scintillation screens as alternatives to conventional, plastic‐based screens. This offers a significant contribution to environmental sustainability by reducing electronic or medical waste. [ABSTRACT FROM AUTHOR]

Operating rooms (ORs) use energy-intensive equipment such as anesthesia gas machines, patient monitors, and lights. They are major contributors to an institution's carbon footprint; yet ORs are unoccupied 40% of the time. Implementing an initiative to power down electrical devices can reduce energy consumption, equipment failure, and financial outlay. This quality improvement project developed and implemented a power down initiative for anesthesia staff to use in ORs. The initiative included turning off anesthesia gas machines, patient monitors, auxiliary oxygen delivery, and room lights at the end of scheduled cases in ORs that were not used for emergencies. Convenience audits were conducted. Pre- and postimplementation compliance outcomes showed that there was an increase in powering down the anesthesia gas machine, patient monitor, auxiliary oxygen, and room lights. Powering down unnecessary equipment at this facility has the potential to save approximately $50,000 and prevent the emission of over 80 metric tons of CO2 per year. Other facilities can implement a similar quality improvement project aimed at fiscal and ecological conservation. [ABSTRACT FROM AUTHOR]

Addressing the pollution problems caused by improper disposal of effluents and wastes from pharmaceutical companies and medical facilities are important for the safety of humans and animals. This work highlights the challenges and developments in medical and pharmaceutical waste management practices across the world as well as their potential for bio-energy production. It involves the study of these waste properties, their impacts on the ecosystem and treatment or recycling methods. Various studies have shown that successes have been recorded in converting some antibiotic contaminated wastewater to biogas in advance anaerobic digesters. Moreover, not all medical wastes are degradable, the use of placentas, hospital cotton waste, human urine, waste blood and surgery waste has been used in biogas plants built at close proximity to hospitals, in some cases. However, such plants are few and are only located in Tanzania, India and Philippines, among others to generate biogas to power hospitals, boil hot water needed by patients and for cooking. This is because the level of awareness as regards the dangers associated with indiscriminate disposal of medical and pharmaceutical waste is low and hence the development of waste disposal policy by countries is often overlooked. The implication of this is the spread of diseases in affected areas which can results in epidemics. It is therefore necessary to formulate policies that allow the harnessing of these wastes to biogas/ bioenergy or the creation of better waste management practices that is environmentally safe. [ABSTRACT FROM AUTHOR]

Strong chemical or voltage‐driven studies of gallium alloys (liquid metal, LM) show methods of altering the surface energy of the bare alloys by controlling Ga2O3 (Gallium Oxide)‐ a 3‐5 nm surface oxide that forms on LM. However, various fluids (i.e., water) interact weakly compared to strong acids or bases and do not etch Ga2O3. Specialized instruments are often required to study such interactions, which are not readily available. Herein, an LM‐based nanoporous conductive wire platform is demonstrated, which can effectively be utilized for real‐time weaker interfacial studies. The unconventional platform allows fluid transport and interfacial studies within the nanoporous domain, which is still foreign in the literature. Nanoporous conductive wires are fabricated by injecting eutectic gallium indium (eGaIn) into hollow microtubes collected from expired and unused artificial kidneys. These steps upcycle medical waste and confine Ga2O3 at the nanopores for an inexpensive metal‐oxide/metal framework. The platform for interfacial fluidics is harnessed, leveraging deionized (DI) water, 1 m hydrochloric acid (HCl), and 95% ethanol (EtOH). This study also demonstrates capacitive sensors that can be immediately implemented using nanoporous conducive wires. Advanced applications from this study suggest that future exploration of such soft systems can lead to more nano/bioanalyses harnessing LM alloys. [ABSTRACT FROM AUTHOR]

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Serological detection of syphilis‐specific antibodies is the most widely used clinical method for diagnosing syphilis. However, the current methods in clinical practice are too diverse, complicating result interpretation and wasting medical resources. To meet the resultant demand for a simple fast naked‐eye detection method, we employed the bacterial cell‐binding domain (CBD) of bacteriophage lysin to functionalize bio‐microparticles (engineered non‐culturable red‐colored Staphylococcus aureus bacteria), forming a bioprobe that can detect the syphilis‐specific antibodies from human serum in 5 min with naked eyes. Specifically, CBD is bioengineered by fusion with one of three antigens of the syphilis‐causing bacteria Treponema pallidum separately. The three resulting fusion proteins bind to the bacteria surface through the CBD motif, generating a bioprobe with the antigens exposed. When the bioprobe is added to the serum samples collected from the syphilis patients, the syphilis‐specific antibodies bind the antigens on the bioprobes and cross‐link them, forming eye‐visible red aggregates for the naked‐eye antibody detection. The bioprobe was validated on 209 clinical samples, revealing its high clinical sensitivity and specificity. Exploiting the natural biorecognition between the bacteria‐specific phage‐derived species and the phage host bacteria represents a promising strategy for producing facile probes for rapid point‐of‐care testing of infectious diseases. [ABSTRACT FROM AUTHOR]

During major epidemic outbreaks, the generation of medical waste has increased dramatically. Medical waste becomes more infectious than usual under these circumstances, and turnover personnel may be affected or become ill due to infection. These unforeseen factors have significantly increased the complexity of task assignment for medical waste turnover personnel. In addition, medical waste requires daily collection and disposal. To ensure the smooth collection of medical waste, the reasonable arrangement of turnover personnel is particularly important. It is well known that the fewer times medical waste turnover personnel are assigned to different temporary storage points for medical waste, the less likely cross-infection occurs. In this paper, aiming to minimize the number of assignments and the number of medical waste turnover personnel assigned, while ensuring a balanced collection task for the assigned medical waste turnover personnel, a multi-objective medical waste turnover personnel assignment model is established, aiming to minimize the number of assignments while ensuring a balanced workload among the assigned personnel. To facilitate solving, this paper converts nonlinear constraints in the model into linear constraints using the Big M method. Finally, based on the medical waste collection and disposal data of a medical waste disposal unit in a certain district of Chengdu city on April 13, 2022, relevant numerical examples are designed and solved using IBM ILOG Cplex Studio IDE 12.7.1, thereby verifying the efficiency and applicability of the model. Our model is designed to provide a relatively rational personnel scheduling plan under the context of major epidemic outbreaks, where the uncertainty for medical waste collection and transportation personnel is heightened. This model aims to minimize the number of personnel required for medical waste collection and transportation while ensuring a balanced workload distribution among them. In comparison to manual scheduling methods, our model significantly enhances the efficiency of scheduling. [ABSTRACT FROM AUTHOR]

Background: The healthcare sector contributes directly to global warming and environmental decline. This is partly due to disproportionately large waste generation compared to other sectors and the environmental consequences of medical waste incineration. Waste separation and recycling decrease the total waste generation of the theatre complex, decreasing the cost of waste disposal, and if properly implemented, can generate revenue. Waste separation is not performed uniformly, and no recycling programmes exist in the theatre complexes of the academic hospitals in Johannesburg. Potentially recyclable anaesthetic waste is not identified in our setting. Methods: Recyclable anaesthetic waste items were identified. Anaesthetic waste was collected after every anaesthetic case. General and medical waste were weighed respectively and inspected for correct separation. Recyclable items were separated from general waste and weighed. Results: A total of 107.6 kg of anaesthetic waste was evaluated. Per anaesthetic case, 74.6% (65.0-84.2%) was medical waste, and 25.4% (15.8-35.0%) was general waste. Of the general waste, 68.8% (57.7-78.8%) was recyclable. Only 6.8% of medical and 61.4% of general waste bags inspected were correctly separated. Within each medical waste bag, 6.9% (2.3-15.5%) of waste was incorrectly placed general waste. Similarly, each general waste bag contained 6% (0-21.6%) incorrectly placed medical waste. Waste generated per surgical discipline was significantly different. Conclusion: Correct waste separation, a key step in decreasing the burden of healthcare waste, was poor. The study demonstrated that most general anaesthetic waste is recyclable. [ABSTRACT FROM AUTHOR]

Background: Disposable non-sterile gloves are part of the personal protective equipment (PPE) to be considered to protect oneself from the risk of infection. They have subsequently become the topic of concern related to increased use, inappropriate use, and potentially increasing the risk of cross-infection and environmental impact of plastic waste. Aim/objective: This study aimed to explore the views of pre-registration student nurses about non-sterile glove use in clinical practice and to identify the factors that impact student nurses' decision on whether to wear non- sterile gloves. Methods: Using a social constructivist approach, the study was organised in a higher education institution. Semi-structured interviews were conducted with second year student nurses, utilising a theoretical domains framework (TDF). Findings/Results: The key findings showed that students had limited awareness of the national infection prevention and control best practice procedures. The primary influential factors for non-sterile gloves use behaviour were personal protection, the type of care interventions required and the observations of peers and role models. Discussion: The study found limited awareness on the importance of infection prevention and control precautions, including the correct procedure for donning, and doffing of personal protection equipment, along with a lack of confidence to challenge non-compliance. [ABSTRACT FROM AUTHOR]

Healthcare is a fundamental aspect of human life, impacting individuals, communities, and societies. Investing in healthcare infrastructure, services, and education is essential for fostering a healthy, thriving population. Healthcare waste management is a critical aspect of public health, and it requires a concerted effort from healthcare facilities, governments, and communities to ensure that waste is managed in a way that minimizes risks to human health and the environment. This paper proposes a hybrid methodology combining the Opinion Weight Criteria Method (OWCM) and the Combinative Distance-Based Assessment (CODAS) within the framework of Triangular Neutrosophic Sets (TNS) to evaluate and select the optimal healthcare waste treatment devices. The proposed methodology balances various conflicting criteria and incorporates uncertainty in expert assessments to ensure a robust decision-making process. The paper also provides a comprehensive review of healthcare waste management devices and highlights the need for a comprehensive approach to healthcare waste management. The proposed methodology is applied to a case study involving evaluating healthcare waste treatment devices based on different factors such as economic, environmental, technological, and social aspects. The results show that the OWCM-CODAS methodology, integrated with TNS, effectively evaluates and ranks healthcare waste treatment devices based on multiple criteria. The sensitivity analysis demonstrates the robustness of the proposed model, and the results indicate that the model's performance and the relative ranking of the alternatives are not sensitive to changes in the threshold parameter τ within the tested range. [ABSTRACT FROM AUTHOR]

The annual production of medical waste from healthcare facilities in Pakistan is around 250,000 tons. An effective waste management system is essential for disposing of hazardous medical waste, and incineration is considered the most effective and accessible technology. Disposal of medical waste ash in landfills without proper treatment could lead to groundwater contamination due to leachate. This research paper aims to evaluate the feasibility of using hospital waste ash obtained from the National Cleaner Production Center (NCPC) in Rawalpindi as a partial replacement for cement. The primary variable in this study was the amount of hospital waste ash (0%, 3%, 7%, and 10% by weight of cement), while the amount of cementitious material, water-to-cement ratio, and fine and coarse aggregate content were kept constant. A total of 36 cubes were cast, with nine cubes for each replacement level for curing periods of 7, 14, and 28 days. The slump value and density of fresh concrete decreased with the increase in the proportion of hospital waste ash in the mix. The compressive strength of mixes with 3% hospital waste ash was higher than that of the control mix. The best results (20.13 MPa) were obtained from the 3% mix after 28 days of curing, while the result obtained with the 7% mix was nearly equal to that of the control mix. [ABSTRACT FROM AUTHOR]