Medical waste management is an essential component of healthcare delivery globally due to the toxic and contagious potentials on human health and the environment. There are resource limitations in developing nations when it comes to the appropriate handling of medical wastes. In this article, we examined previous studies to evaluate the practices of medical waste management in China and Nigeria. Contextually, this work addresses medical waste practices in the context of waste generation, segregation, collection, storage, transportation, treatment and disposal. In addition to reviewing additional important aspects of medical waste management, the current study addresses potentials and challenges for efficient medical waste management in both countries. For this study; Scopus, Web of Science, Google Scholar, PubMed, Agencies, Conferences, National and International Conventions were searched from 1998 up to 2023 for all studies reporting medical waste management in China and Nigeria. To further guarantee that only resource materials with similar research interests in medical waste management were selected, a double screening process was employed. The challenges of medical waste management in both countries are limited financing, inadequate training, ineffective legislation, ineffective medical waste transport system and insufficient treatment technology. Furthermore, this study offers practical recommendations by identifying the particular areas that require attention and development, such as training of healthcare workers, adequate financing of medical waste management projects, including research and development on efficient toxic emission reducing technologies, and partnership with other relevant authorities and stakeholders to ensure enforcement of national and local legislation.

The COVID-19 pandemic greatly accelerated the use of online technologies for communication, as opposed to contact involving physical presence and touch. This commentary further considers the consequences of this change in individual human terms, in everyday as well as medical situations. It is a kind of discussion paper, specially written for this journal. It develops two directions of argument, the first about the reality of embodiment, the second about figures of speech involving touch and movement, figures of speech about the actions of whole people rather than about mind (spirit) or body separately. The discussion reviews the nature of differences between communication involving physical proximity and physical distance (and electronic media), with comments on the positive and negative aspects of each. An emphasis on the significance of touch (and movement, since all touch involves movement) to people is linked to the basic aspects of the lifecycle in birth, reproduction, and death. In conclusion, the discussion emphasizes the traditional importance of touch and physical participation to people\'s feeling for reality. New digital forms of relations disturb this feel, with significant consequences.
Пандемия COVID-19 в значительной мере способствовала стремительному внедрению онлайн-технологий для их использования с целью общения, заменив контакты, предполагающие физическое присутствие и прикосновение. В данной статье, носящей дискуссионный характер, подробно рассматриваются последствия этого изменения для отдельного человека, как в повседневных бытовых и социальных, так и в медицинских ситуациях. В ходе обсуждения развиваются два направления аргументации: первое — о реальности телесного взаимодействия (прикасаний), второе — о фигурах речи, связанных с коммуникативными взаимодействиями и движением, а также о действиях людей в целом, а не движения разума (духа) или тела по отдельности. Подробно рассматривается природа различий между общением, которое включает физическую близость, и которое осуществляется на расстоянии (дистанционно, с использованием электронных средств передачи информации), с комментариями о положительных и отрицательных аспектах каждого из способов коммуникации. Особое внимание уделяется значению для человека факта прикосновения (и движения, поскольку любое прикосновение предполагает движение), которое связано с основными аспектами жизненного цикла рождения, воспроизведения потомства и смерти. В заключении дискуссии подчеркивается традиционная важность прикосновений и физического участия для создания у людей ощущения реальности. Новые цифровые форматы отношений нарушают это ощущение, что влечет за собой значительные последствия — нарушение ощущения реальности, непринятие социально обусловленных границ взаимодействия и др.

Porphyromonas gingivalis is a gram-negative anaerobic bacterium recognized for its pivotal role in the pathogenesis of periodontal diseases. This review covers an overview of the virulence factors and lifecycle stages of P. gingivalis, with a specific focus on attachment and colonization, biofilm formation, growth and multiplication, dormancy survival and dissemination. Additionally, we explore the significance of inter-bacterial cross-feeding within biofilms. Furthermore, we discuss potential phytochemical-based strategies to target P. gingivalis, including the use of curcumin, apigenin, quercetin and resveratrol. Understanding the virulence factors and lifecycle stages of P. gingivalis, along with the promising phytochemical-based interventions, holds promise for advancing strategies in periodontal disease management and oral health promotion.

To ensure the safe use of materials, one must assess the identity and quantity of exposure. Solid materials, such as plastics, metals, coatings and cements, degrade to some extent during their life cycle, and releases can occur during manufacturing, use and end-of-life. Releases (e.g., what is released, how does release happen, and how much material is released) depend on the composition and internal (nano)structures of the material as well as the applied stresses during the lifecycle. We consider, in some depth, releases from mechanical, weathering and thermal stresses and specifically address the use cases of fused-filament 3D printing, dermal contact, food contact and textile washing. Solid materials can release embedded nanomaterials, composite fragments, or micro- and nanoplastics, as well as volatile organics, ions and dissolved organics. The identity of the release is often a heterogenous mixture and requires adapted strategies for sampling and analysis, with suitable quality control measures. Control materials enhance robustness by enabling comparative testing, but reference materials are not always available as yet. The quantity of releases is typically described by time-dependent rates that are modulated by the nature and intensity of the applied stress, the chemical identity of the polymer or other solid matrix, and the chemical identity and compatibility of embedded engineered nanomaterials (ENMs) or other additives. Standardization of methods and the documentation of metadata, including all the above descriptors of the tested material, applied stresses, sampling and analytics, are identified as important needs to advance the field and to generate robust, comparable assessments. In this regard, there are strong methodological synergies between the study of all solid materials, including the study of micro- and nanoplastics. From an outlook perspective, we review the hazard of the released entities, and show how this informs risk assessment. We also address the transfer of methods to related issues such as tyre wear, advanced materials and advanced manufacturing, biodegradable polymers, and non-solid matrices. As the consideration of released entities will become more routine in industry via lifecycle assessment in Safe-and-Sustainable-by-Design practices, release assessments will require careful design of the study with quality controls, the use of agreed-on test materials and standardized methods where these exist and the adoption of clearly defined data reporting practices that enable data reuse, meta-analyses, and comparative studies.

Significant events impacting healthcare over the last several years have been associated with escalating rates of healthcare-associated infections. This has resulted in increased efforts to reinstitute well-established and evidence-based infection prevention practices, particularly for central line associated bloodstream infections. However, implementation of prevention initiatives beyond central lines has not received the same level of acknowledgement and response as being a considerable risk to patients. This article, authored by infection prevention, infectious disease, and vascular access professionals, provides emerging perspectives and technical aspects associated with the complete lifecycle of a vascular access device. The intent is to provide insight and perspective into enhancing current IP practices in the acute care hospital setting. This will also help prepare hospitals for upcoming broader surveillance and intervention activities aimed at reducing Hospital Onset Bacteremia and Fungemia (HOB) associated with all types of vascular access devices.

We approach the questions, what part of evolutionary change results from selection, and what is the adaptive information flow into a population undergoing selection, as a problem of quantifying the divergence of typical trajectories realized under selection from the expected dynamics of their counterparts under a null stochastic-process model representing the absence of selection. This approach starts with a formulation of adaptation in terms of information and from that identifies selection from the genetic parameters that generate information flow; it is the reverse of a historical approach that defines selection in terms of fitness, and then identifies adaptive characters as those amplified in relative frequency by fitness. Adaptive information is a relative entropy on distributions of histories computed directly from the generators of stochastic evolutionary population processes, which in large population limits can be approximated by its leading exponential dependence as a large-deviation function. We study a particular class of generators that represent the genetic dependence of explicit transitions around reproductive cycles in terms of stoichiometry, familiar from chemical reaction networks. Following Smith (2023), which showed that partitioning evolutionary events among genetically distinct realizations of lifecycles yields a more consistent causal analysis through the Price equation than the construction from units of selection and fitness, here we show that it likewise yields more complete evolutionary information measures.

Technological advancements, improved surgical access, and heightened demand for surgery have fueled unprecedented device and supply turnover impelling wealthy hospitals to upgrade continually and sell, donate, recycle, or dispose of used, expired, antiquated, or surplus goods. This paper reviews the issues related to device and supply lifecycles and discusses the opportunities and challenges they present for sustainable surgical growth in low- and middle-income (LMICs) countries.
This review found, in LMICs countries, regulatory disparities persist that limit effective harmonization secondary to highly variable national policies and a lack of prioritized enforcement. Heterogeneity in the regulatory landscape, specifically in the classification, nomenclature, and identification of medical devices, encumbers effective regulation and distribution. Once devices are sold, donated, or reused in LMICs countries, complexities arise in regulatory compliance, maintenance, and appropriate use of these technologies. At the end of the lifecycle, waste management poses significant obstacles with limited resources hindering the implementation of best practices.
There are major disparities in access to quality surgical equipment and supplies around the world. Improved communication between relevant stakeholders and harmonization of manufacture and disposal regulations will be needed to ensure adequate and appropriate responses to these challenges.
Not applicable.

Hypercholesterolemia is a major risk factor for atherosclerotic cardiovascular disease leading to reduced (healthy) life years. The aim of this study is to quantify the societal costs associated with hypercholesterolemia. We use epidemiologic data on the distribution of cholesterol levels as well as data on relative risks regarding ischemic heart disease, stroke, and other cardiovascular diseases. The analytical approach is based on the use of population-attributable fractions applied to direct medical, direct non-medical and indirect costs using data of Austria. Within a life-cycle analysis we sum up the costs of hypercholesterolemia for the population of 2019 and, thus, consider future morbidity and mortality effects on this population. Epidemiologic data suggest that approximately half of Austria\'s population have low-density lipoprotein cholesterol (LDL-C) levels above the target levels (i.e., are exposed to increased risk). We estimate that 8.2% of deaths are attributable to hypercholesterolemia. Total costs amount to about 0.33% of GDP in the single-period view. In the life-cycle perspective, total costs amount to €806.06 million, €312.1 million of which are medical costs, and about €494 million arise due to production loss associated with hypercholesterolemia. The study points out that significant shares of deaths, entries into disability pension and care allowance, full-time equivalents lost to the labor market as well as monetary costs for the health system and the society could be avoided if LDL-C-levels of the population were reduced.

Tropical infectious diseases inflict an unacceptable burden of disease on humans living in developing countries. Although anti-pathogenic drugs have been widely used, they carry a constant threat of selecting for resistance. Vaccines offer a promising means by which to enhance the global control of tropical infectious diseases; however, these have been difficult to develop, mostly because of the complex nature of the pathogen lifecycles. Here, we present recently developed vaccine candidates for five tropical infectious diseases in the form of a catalog that have either entered clinical trials or have been licensed for use. We deliberate on recently licensed dengue vaccines, provide evidence why combination vaccination could have a synergistic impact on schistosomiasis, critically appraise the value of typhoid conjugate vaccines, and discuss the potential of vaccines in the efforts to eliminate vivax malaria and hookworms.

Bioplastics have been used as alternatives to conventional petroleum-based plastics to lessen the burdens on marine and terrestrial environments due to their non-biodegradability and toxicity. However, recent studies have shown that not all bioplastics may be environmentally friendly. Microalgae, such as Spirulina that do not require arable land, have been identified as a potential bioplastic source. In this study, cradle-to-gate life cycle assessment (LCA) was carried out in openLCA program using the Agribalyse database, to evaluate the environmental impacts of Spirulina bioplastic, formed from plasticization of Spirulina powder with glycerol. Two processes were created for the inventories of (i) Spirulina powder and (ii) Spirulina bioplastic, where the output of the former served as an input for the latter. The extruded bioplastic sheets were food-grade and could be used as edible packaging materials. The bioplastic was also compared to conventional plastics and it was found that the energy consumption was 3.83 ± 0.26 MJ/kg-bioplastic, which was 12% and 22% higher than that of LDPE and PVC plastic films, respectively. The impacts on the environment showed that the chemical growth medium (Zarrouk medium) and electricity were the main contributors in most of the categories. Compared to the PVC and LDPE films, the Spirulina bioplastic\'s impacts on the aquatic ecosystems were 2-3 times higher. The global warming potential of the Spirulina bioplastic was 1.99 ± 0.014 kg CO2 eq, which was 23% and 47% lower than that of LDPE and PVC films, respectively. Sensitivity analysis was carried out by changing the electricity source and using alternative growth media. Except for the case of switching to solar energy, the results for other cases did not differ significantly from the base case scenario. Future studies were suggested to identify different greener alternatives to the growth medium as well as different energy mixes for more environmentally benign solutions.