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Biological polyesters of hydroxyacids are known as polyhydroxyalkanoates (PHA). They have proved to be an alternative, environmentally friendly and attractive candidate for the replacement of petroleum-based plastics in many applications. Many bacteria synthesize these compounds as an intracellular carbon and energy compound usually under unbalanced growth conditions. Biodegradability and biocompatibility of different PHA has been studied in cell culture systems or in an animal host during the last few decades. Such investigations have proposed that PHA can be used as biomaterials for applications in conventional medical devices such as sutures, patches, meshes, implants, and tissue engineering scaffolds as well. Moreover, findings related to encapsulation capability and degradation kinetics of some PHA polymers has paved their way for development of controlled drug delivery systems. The present review discusses about bio-plastics, their characteristics, examines the key findings and recent advances highlighting the usage of bio-plastics in different medical devices. The patents concerning to PHA application in biomedical field have been also enlisted that will provide a brief overview of the status of research in bio-plastic. This would help medical researchers and practitioners to replace the synthetic plastics aids that are currently being used. Simultaneously, it could also prove to be a strong step in reducing the plastic pollution that surged abruptly due to the COVID-19 medical waste.

There are millions of waste pickers worldwide that are predominantly located in low- and middle-income countries. They survive on sorting and selling reusable orrecyclable materials discarded by society.While sorting, they are exposed to occupational risks and hazards, including cuts from sharp objects and medical wastes, that could be contaminated by infectious diseases. Because of these exposures, a study was conducted to determine the prevalence of syphilis and other sexually transmitted infections (STI's) among waste pickers. A cross-sectional study using a semi-structured questionnaire and blood samples for serological tests were collected. A total of 1,025 waste pickers were interviewed. Most participants were women (67.54%), without a partner (70.11%), were an average of 40 years old, and had between 3 and 4 children. There were 755 samples collected for syphilis, 791 for HIV, 866 for hepatitis B, and 859 for hepatitis C. Of these samples, 28 (3.70%) waste pickers had reagent serology for syphilis, 6 (0.75%) for HIV; 6 (0.69%) for acute hepatitis B and 1 (0.11%) for hepatitis C. Overall, this study identified the serological status of waste pickers; this information can be used to encourage waste pickers to seek health treatment for STIs and receive education to understand the risks associated with being exposed to medical waste or syringes.

Climate change and environmental pollution from health care present urgent, complex challenges. The US health care sector produces 10% of total US greenhouse gas emissions, which have negative influences on human and environmental health. The emergency department (ED) is an important place in the hospital to become more environmentally responsible and "climate smart," a term referring to the combination of low-carbon and resilient health care strategies. Our intent is to educate and motivate emergency providers to action by providing a guide to sustainable health care and an approach to creating a climate-smart ED.

Perinatal tissues are an abundant source of human extracellular matrix proteins, growth factors and stem cells with proved potential use in a wide range of therapeutic applications. Due to their placental origin, these tissues possess unique biological properties, including being angiogenic, anti-inflammatory, anti-fibrotic, anti-microbial and immune privileged. Additionally, as a temporary organ, placenta is usually discarded as a medical waste, thus providing an easily available, cost effective, 'unlimited' and ethical source of raw materials. Although some of these tissues, such as the amniotic membrane and umbilical cord, have been used in clinical practices, most of them continue to be highly under explored. This review aims to outline the most relevant applications of perinatal tissues as a source of biomaterials and stem cells in the exciting fields of tissue engineering and regenerative medicine (TERM), as well as highlight how these solutions can be used to overcome the shortage of adequate scaffolds and cell sources that currently hampers the translation of TERM strategies towards clinical settings. STATEMENT OF SIGNIFICANCE: Stem cells and extracellular matrix derived from perinatal tissues such as placenta and umbilical cord, have drawn great attention for use in a wide variety of applications in the biomedical field. Due to their origin, these tissues possess unique biological properties, including being angiogenic, anti-inflammatory, anti-fibrotic, anti-microbial and immune privileged. Also they are typically considered medical waste, thus providing an easily available, cost effective, 'unlimited' and ethical source of raw materials. This work aims to present and discuss the most relevant applications of perinatal tissues as a source of biomaterials and stem cells in the exciting fields of tissue engineering and regenerative medicine (TERM). published

In order to grasp the suppression mechanisms of polycyclic aromatic hydrocarbons (PAHs) formation by coarser-sized bed material in the process of solid waste incineration. Medical waste incineration with silica bed materials under three particle sizes (160–180 μm, 180–250 μm and 250–320 μm) was carried out in a fluidized bed combustor (FBC). The distributions and contents of PAHs, monocyclic aromatic hydrocarbons (MAHs) and light hydrocarbons along the vertical direction (0.4, 0.7 and 1.0 m) were also measured. The results showed that the PAHs concentrations in flue gas had a positive correlation with the concentrations of MAHs and light hydrocarbon during medical waste incineration. The suppression of PAHs formation by the coarser-sized silica (250–320 μm) bed material was mainly attributed to the lower heat transfer rate between the bed material and medical wastes, which resulted in slower evolution rates of MAHs and light hydrocarbon, thus inhibiting the formation of MAHs, light hydrocarbon and PAHs.

The massive generation of medical waste (MW) results in a series of environmental, social, and ecological problems. Pyrolysis is one such approach that has attracted more attention because of the production of value-added products with lesser environmental risk. In this study, the activated biochar (ABC600) was obtained from MW pyrolysis and activated with KOH. The adsorption mechanism of activated biochar on cationic (methylene blue) and anionic (reactive yellow) dyes were studied. The physicochemical characterization of biochar showed that increasing pyrolysis temperature and KOH activation resulted in increased surface area, a rough surface with a clear porous structure, and sufficient functional groups. MB and RYD-145 adsorption on ABC600 was more consistent with Langmuir isotherm (R

Dependency on plastic commodities has led to a recurrent increase in their global production every year. Conventionally, plastic products are derived from fossil fuels, leading to severe environmental concerns. The recent coronavirus disease 2019 pandemic has triggered an increase in medical waste. Conversely, it has disrupted the supply chain of personal protective equipment (PPE). Valorisation of food waste was performed to cultivate C. necator for fermentative production of biopolymer poly(3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV). The increase in biomass, PHBV yield and molar 3-hydroxy valerate (3HV) content was estimated after feeding volatile fatty acids. The fed-batch fermentation strategy reported in this study produced 15.65 ± 0.14 g/L of biomass with 5.32 g/L of PHBV with 50% molar 3HV content. This is a crucial finding, as molar concentration of 3HV can be modulated to suit the specification of biopolymer (film or fabric). The strategy applied in this study addresses the issue of global food waste burden and subsequently generates biopolymer PHBV, turning waste to wealth.

The world has been grappling with the crisis of the COVID-19 pandemic for more than a year. Various sectors have been affected by COVID-19 and its consequences. The waste management system is one of the sectors affected by such unpredictable pandemics. The experience of COVID-19 proved that adaptability to such pandemics and the post-pandemic era had become a necessity in waste management systems and this requires an accurate understanding of the challenges that have been arising. The accurate information and data from most countries severely affected by the pandemic are not still available to identify the key challenges during and post-COVID-19. The documented evidence from literature has been collected, and the attempt has been made to summarize the rising challenges and the lessons learned. This review covers all raised challenges concerning the various aspects of the waste management system from generation to final disposal (i.e., generation, storage, collection, transportation, processing, and burial of waste). The necessities and opportunities are recognized for increasing flexibility and adaptability in waste management systems. The four basic pillars are enumerated to adapt the waste management system to the COVID-19 pandemic and post-COVID-19 conditions. Striving to support and implement a circular economy is one of its basic strategies.

Algorithms that estimate the location and magnitude of an atmospheric release using remotely sampled air concentrations typically involve a single chemical or radioactive isotope. A new Bayesian algorithm is presented that makes discrimination between possible types of releases (e.g., nuclear explosion, nuclear power plant, or medical isotope production facility) an integral part of the analysis for samples that contain multiple isotopes. Algorithm performance is demonstrated using synthetic data and correctly discriminated between most release-type hypotheses, with higher accuracy when data are available on three or more isotopes.

The present work mainly deals with the efficacy of the waste medical grade cotton (MGC) used for the sustainable self-reinforced composite (SRC). MGC waste was exposed in the autoclave for destroying all microorganisms including infected bacteria's and virus followed by scoured and bleached for removing blood stains and foreign materials. SRC film was prepared by selective dissolved fibre surface of waste MGC into a dissolved microcrystalline cellulose (DMCC) matrix solution prepared by lithium chloride/N,N-dimethylacetamide (LiCl/DMAc) solvent system. The tensile strength of SRC films was significantly improved up to 252 MPa, and it was higher than that of the DMCC film. In the FTIR study, no peak was found in 1620 cm−1 in SRC confirming that the LiCl/DMAc has been completely removed. SEM study also revealed the presence of partial dissolution of the surface of MGC which merged with DMCC matrix in the SRC. The XRD results displayed higher crystallinity SRC than DMCC film. The thermal stability of SRC as determined by TGA improved compared to the DMCC film from 225 °C for DMCC to 250–283 °C for SRC films. Therefore, these prominent results revealed the potential utilization of a sustainable resource, waste MGC in producing environmentally friendly SRC films with high-performance properties.

Disposal of medical waste (MW) must be considered as a vital need to prevent the spread of pandemics during Coronavirus disease of the pandemic in 2019 (COVID-19) outbreak in the globe. In addition, many concerns have been raised due to the significant increase in the generation of MW in recent years. A structured evaluation is required as a framework for the quantifying of potential environmental impacts of the disposal of MW which ultimately leads to the realization of sustainable development goals (SDG). Life cycle assessment (LCA) is considered as a practical approach to examine environmental impacts of any potential processes during all stages of a product's life, including material mining, manufacturing, and delivery. As a result, LCA is known as a suitable method for evaluating environmental impacts for the disposal of MW. In this research, existing scenarios for MW with a unique approach to emergency scenarios for the management of COVID-19 medical waste (CMW) are investigated. In the next step, LCA and its stages are defined comprehensively with the CMW management approach. Moreover, ReCiPe2016 is the most up-to-date method for computing environmental damages in LCA. Then the application of this method for defined scenarios of CMW is examined, and interpretation of results is explained regarding some examples. In the last step, the process of selecting the best environmental-friendly scenario is illustrated by applying weighting analysis. Finally, it can be concluded that LCA can be considered as an effective method to evaluate the environmental burden of CMW management scenarios in present critical conditions of the world to support SDG.

Increased plastic uses during COVID-19 pandemic challenges efforts to reduce marine plastic debris. Despite recent observations of increased plastic-made personal protection equipment (PPE) waste in coastal areas, comparative data before and during the pandemic lacked. We present in situ monitoring data on riverine debris releases into Jakarta Bay, Indonesia, during COVID-19 pandemic relative to the 2016 baseline data. River debris at two river outlets – the Cilincing and Marunda Rivers, revealed a 5% increase in the abundance of debris and a 23–28% decrease in the weight of debris releases in March–April 2020 compared to March–April 2016, suggesting a compositional shift towards lighter debris. Plastics continued to dominate river debris at 46% (abundance) or 57% (weight). Unique to the pandemic, we observed an unprecedented presence of PPE (medical masks, gloves, hazard suits, face shields, raincoats) that accounted for 15–16% of the collected river debris of 780 ± 138 items (abundance) or 0.13 ± 0.02 tons (weight) daily. The observed increased plastic-made PPE in river outlets urges for improved medical waste management of domestic sources during the prolonged pandemic., Highlights • Riverine debris releases into Jakarta Bay during the COVID-19 pandemic were monitored. • Riverine debris increased by abundance while decreased by weight during the pandemic. • Plastics dominated riverine debris at 46% by abundance and 57% by weight. • The presence of plastic-made personal protection equipment was unprecedented during the pandemic. Plastic-made personal protection equipment accounted for 15–16% of the collected river debris.

In this study we have aimed to build an automatic computer vision based medical waste separator that detects the presence of medical waste and categorizes them into one of the four categories namely gloves, mask, syringe and cotton. This embedded system uses transfer learning on the AlexNet deep learning network to train a model which classifies medical waste. The hardware set up is designed to detect the movement of the lid of the input bin and then capture an image of the waste object dropped into the bin. This image is then fed to our trained model which classifies the object with a 86.17\% validation accuracy. Once the model classifies it, the waste object is dropped into the correct bin with the help of servo motors. This embedded system has been tested with different types of gloves, mask, syringe and cotton samples and presents a convenient way to segregate medical waste successfully. Thus this system aims to eliminate the need for manual labour to segregate hazardous medical waste and avoids harmful exposure to contaminated waste.

The COVID-19 pandemic caused by SARS-CoV-2 has posed a huge threat to mankind, deeply endangering healthy states and influencing economic development. COVID-19 has important impacts on the environment as anthropic interventions to nature has been largely reduced after almost all countries implemented partial or complete blockade to curb the spread of the virus. Up to now, a series of studies have focused on the relationship between COVID-19 and the environment from different cities. In this review, we summarized the latest data on the correlation between COVID-19 and environmental changes. As a result, imposing necessary restrictions can help suppress the virus chain while improving air quality in some countries. The significant reduction in NO2 emission, PM2.5 level and other hazardous factors reflected the promising consequence of the efforts made during the lockdown period. It is, sometimes dark clouds have silver linings. It is worth noting that along with these positive outcomes, secondary pollutants such as ozone, however, remained unchanged or even increased significantly. Additionally, medical wastes and plastics pollutants would be increased substantially. The extensive use of masks in daily life and other medical materials is bound to increase the burden of waste disposal and environmental degradation. For the general public, in addition to the physical lesions caused by SARS-CoV-2, confirmed/suspected cases and even the normal group may suffer from mental problems. Based on those mentioned impacts, the way forward depends largely on our attitude and decision. It is indispensable to assess potential deleterious effects and to take preventive measures in time to respond to the post-pandemic era. In this way, potential silver linings will not become temporary., Graphical abstract Unlabelled Image, Highlights • During the lockdown period, a significant reduction in NO2 and PM2.5 level has been observed. • Secondary pollutants such as ozone remain unchanged or even increase substantially. • Increased demands in masks and packaging materials would aggravate micro/nanoplastic pollution. • People experienced SARS-CoV-2 are relatively afflicted with psychological trauma. • It is essential to assess the social impacts and establish a comprehensive system for the post-pandemic era.

The recent pandemic triggered by the outbreak of the novel coronavirus boosted the demand for medical services and protective equipment, causing the generation rate of infectious medical waste (IMW) to increase rapidly. Designing an efficient and reliable IMW reverse logistics network in this situation can help to control the spread of the virus. Studies on this issue are limited, and minimization of costs and the risks associated with the operations of this network consisting of different types of medical waste generation centers (MWGC) are rarely considered. In this research, a linear programming model with three objective functions is developed to minimize the total costs, the risk associated with the transportation and treatment of IMW, and the maximum amount of uncollected waste in MWGCs. Also, multiple functions that calculate the amount of generated waste according to the parameters of the current epidemic outbreak are proposed. Revised Multi-Choice Goal Programming method is employed to solve the multi-objective model, and a real case study from Iran is examined to illustrate the validation of the proposed model. The final results show that the model can create a balance between three considered objectives by determining the flow between centers, deciding to install two new temporary treatment centers, and allowing the network to only have uncollected waste in the first two periods in some MWGCs. Also, managerial insights for health organization authorities extracted from the final results and sensitivity analyses are presented for adequately handling the IMW network., Graphical abstract Unlabelled Image, Highlights • Proposing a model compatible with condition of epidemic outbreak or pandemic • Minimizing cost and risk of handling infectious medical waste in epidemic outbreak • Minimizing the maximum uncollected waste in medical waste generation centers • Designed functions that calculate amounts of waste based on parameters of the virus • Considering all potential centers that generate infectious medical waste

COVID-19 pandemic-borne wastes imposed a severe threat to human lives as well as the total environment. Improper handling of these wastes increases the possibility of future transmission. Therefore, immediate actions are required from both local and international authorities to mitigate the amount of waste generation and ensure proper disposal of these wastes, especially for low-income and developing countries where solid waste management is challenging. In this study, an attempt is made to estimate healthcare waste generated during the COVID-19 pandemic in Bangladesh. This study includes infected, ICU, deceased, isolated and quarantined patients as the primary sources of medical waste. Results showed that COVID-19 medical waste from these patients was 658.08 tons in March 2020 and increased to 16,164.74 tons in April 2021. A top portion of these wastes was generated from infected and quarantined patients. Based on survey data, approximate daily usage of face masks and hand gloves is also determined. Probable waste generation from COVID-19 confirmatory tests and vaccination has been simulated. Finally, several guidelines are provided to ensure the country's proper disposal and management of COVID-related wastes., Graphical abstract Unlabelled Image

The surge of medical waste (MW) generated during the COVID-19 pandemic has exceeded the disposal capacity of existing facilities. The timely, safe, and efficient emergency disposal of MW is critical to prevent the epidemic spread. Therefore, this review presents the current status of MW generation and disposal in China and analyzes the characteristics and applicability of emergency disposal technologies. The results show that movable disposal facilities can dispose of infectious MW on site, even though most of their disposal capacity is at a low level (, Graphical abstract Unlabelled Image

The outbreak of COVID-19 has caused concerns globally. On 30 January WHO has declared it as a global health emergency. The easy spread of this virus made people to wear a mask as precautionary route, use gloves and hand sanitizer on a daily basis that resulted in generation of a massive amount of medical wastes in the environment. Millions of people have been put on lockdown in order to reduce the transmission of the virus. This epidemic has also changed the people's life style; caused extensive job losses and threatened the sustenance of millions of people, as businesses have shut down to control the spread of virus. All over the world, flights have been canceled and transport systems have been closed. Overall, the economic activities have been stopped and stock markets dropped along with the falling carbon emission. However, the lock down of the COVID-19 pandemic caused the air quality in many cities across the globe to improve and drop in water pollutions in some parts of the world., Graphical abstract Unlabelled Image, Highlights • COVID-19 has been declared as a global health emergency due to spread of corona virus. • To prevent the transmission mask, surgical gloves and sanitizer were used. • It has led to generation of massive amount of medical wastes in the environment. • Millions of people have been placed under lockdown to reduce the transmission. • Reduction in economic activities and improved air and water quality across the globe.

To dispose of the medical waste generated during the COVID-19 pandemic, a new type of mobile emergency incinerator (MEI) was used in Huoshenshan Hospital, Wuhan, China, and consequently, it produced a number of medical bottom ashs (MBAs). In this study, the characterization and environmental risk evaluation of these MBAs were conducted to evaluate the disposal effect of this MEI used during the pandemic. Three types of leaching tests, EN 12457–2, TCLP 1311, and HJ/T 299–2007, were compared to investigate the release behaviors of major and trace elements from these MBAs. Lack of detection of COVID-19 in MBAs showed that this mobile emergency incinerator could thoroughly eliminate the COVID-19 virus in medical wastes to avoid secondary transmission. The results indicated that the increasing usage of chlorinated disinfectants and physiological saline solutions resulted in high Cl contents in MBAs. In addition, the increasing usage of polypropylene (PP) products changed the chemical properties and compositions of MBAs, with Ca as the main element. The leachability investigation revealed that the main metals in leachates were Ca, Na and K, and the toxic heavy metals such as Zn, Pb, Cu, and Cr in MBAs were difficult to extract because of the high pH (>12) of these MBAs. This study could provide consultation for the treatment and management of MBAs produced from MEIs dealing with emergent infectious diseases such as COVID-19., Graphical abstract Image 1

Herbal medicine wastes (HMWs) are byproducts of medicine factories, which are mainly landfilled for their environmental problems. Only bearing in mind the contamination and concerns caused by the COVID-19 pandemic and environmental emissions, the worth of herbal medicine wastes management and conversion to green products can be understood. In this work, subcritical water treatment was carried out batch-wise in a stainless tube reactor in the pressure range of 0.792-30.0 MPa, varying the temperature (127-327 °C) and time (1-60 min) of extraction. This resulted in new and green material sources, including organic acids, amino acids, and sugars. Amazingly, at very low extraction times (below 5 min) and high temperatures (above 277 °C), about 99% of HMWs were efficaciously converted to clean products by subcritical hydrothermal treatment. The results of hydrothermal extraction after 5 min indicated that at low temperatures (127-227 °C), the total organic carbon in the aqueous phase increased as the residual solid phase decreased, reaching a peak around 220 °C. Acetone soluble extracts or fat phase appeared above 227 °C and reached a maximum yield of 21% at 357 °C. Aspartic acid, threonine, and glycine were the primary amino acids; glycolic acid, formic acid, lactic acid, and acetic acid were obtained as the main organic acids, glucose, fructose, and cellobiose were substantial sugars produced from the aqueous phase after 5 min of hydrothermal subcritical hydrolysis extraction.

Improper healthcare waste (HCW) management poses significant risks to the environment, human health, and socio-economic sustainability due to the infectious and hazardous nature of HCW. This research aims at rendering a comprehensive landscape of the body of research on HCW management by (i) mapping the scientific development of HCW research, (ii) identifying the prominent HCW research themes and trends, and (iii) providing a research agenda for HCW management towards a circular economy (CE) transition and sustainable environment. The analysis revealed four dominant HCW research themes: (1) HCW minimization, sustainable management, and policy-making; (2) HCW incineration and its associated environmental impacts; (3) hazardous HCW management practices; and (4) HCW handling and occupational safety and training. The results showed that the healthcare industry, despite its potential to contribute to the CE transition, has been overlooked in the CE discourse due to the single-use mindset of the healthcare industry in the wake of the infectious, toxic, and hazardous nature of HCW streams. The findings shed light on the HCW management domain by uncovering the current status of HCW research, highlighting the existing gaps and challenges, and providing potential avenues for further research towards a CE transition in the healthcare industry and HCW management.

Prior studies primarily suggest that the generation of medical wastes maintains a positive relationship with national incomes. In contrast, higher incomes may lead to improved health status, consequently resulting in lower generation of medical wastes. Under this circumstance, an inverted U-shaped curve may be used to describe the generation of medical wastes along with economic growth. Additionally, illegal disposal is believed to have a high impact on human health. Thus, the purpose of this paper is to examine the presence of the environmental Kuznets curve for both the generation and illegal disposal of medical wastes by using a model of the environmental Kuznets curve. The results find the generation of medical wastes is positively affected by incomes, but this paper identifies the existence of the environmental Kuznets curve phenomenon for illegal disposal. Both the generation and illegal disposal of medical wastes are positively affected by medical capacity but negatively affected by medical policy. The primary contributions of this paper are three-fold. First, this paper is the first to focus on the existence of the environmental Kuznets curve phenomenon for both the generation and the illegal disposal of medical wastes. Second, this paper confirms the existence of the environmental Kuznets curve for the illegal disposal of medical wastes. Illegal disposal may be blocked when national incomes reach a specific level, and thus, the government may focus on the formulation of medical policy to encourage reduced demand for medical care. Third, this paper finds that the implementation of medical policy may have an important effect on inhibiting the generation and illegal disposal of medical wastes.

Diabetes, a metabolic disorder of glucose, is a serious chronic disease and an important public health problem. Insulin is one of the hormones for modulating blood glucose level and the products of which is indispensable for most diabetes patients. Introducing microneedles (MNs) to insulin delivery is promising to pave the way for modulating glucose level noninvasively of diabetes patients, as which born to be painless, easy to handle and no need of any power supply. In this work, we review the process of insulin delivery systems (IDSs) based on MN technology in terms of two categories: drug free MNs and drug loaded MNs. Drug free MNs include solid MNs ("poke and patch"), hollow MNs ("poke and flow") and reservoir-based swelling MNs ("poke and swell R-type"), and drug loaded MNs include coated MNs ("coat and poke"), dissolving MNs ("poke and release") and insulin incorporated swelling MNs ("poke and swell I-type"). Majority researches of MN-based IDSs have been conducted by using hollow MNs or dissolving MNs, and almost all clinical trials for MN-based IDSs have employed hollow MNs. "Poke and patch" approach dramatically increase skin permeability compared to traditional transdermal patch, but MNs fabricated from silicon or metal may leave sharp waste in the skin and cause a safety issue. "Poke and flow" approach, similar to transitional subcutaneous (SC) injection, is capable of producing faster insulin absorption and action than SC injection but may associate with blockage, leakage and low flow rate. Coated MNs are able of retaining the activity of drug, which loaded in a solid phase, for a long time, however have been relatively less studied for insulin application as the low drug dosing. "Poke and release" approach leaves no biohazardous sharp medical waste and is capable of rapid drug release. "Poke and swell R-type" can be seen as a combination of "poke and flow" and "poke and patch" approach, while "poke and swell I-type" is an approach between "coat and poke" and "poke and release" approach. Insulin MNs are promising for painless diabetes therapeutics, and additional efforts for addressing fundamental issues including the drug loading, the PK/PD profile, the storage and the safety of insulin MNs will accelerate the clinical transformation.

Highlights • Waste management is overlooked in the containment of highly infectious pathogens. • Complexities of category A waste deter facilities' willingness to accept the waste. • Enhanced training on properly handling and transporting category A waste is urged., Background The recent Ebola outbreak led to the development of Ebola virus disease (EVD) best practices in clinical settings. However, after the care of EVD patients, proper medical waste management and disposal was identified as a crucial component to containing the virus. Category A waste—contaminated with EVD and other highly infectious pathogens—is strictly regulated by governmental agencies, and led to only several facilities willing to accept the waste. Methods A pilot survey was administered to determine if U.S. medical waste facilities are prepared to handle or transport category A waste, and to determine waste workers' current extent of training to handle highly infectious waste. Results Sixty-eight percent of survey respondents indicated they had not determined if their facility would accept category A waste. Of those that had acquired a special permit, 67% had yet to modify their permit since the EVD outbreak. This pilot survey underscores gaps in the medical waste industry to handle and respond to category A waste. Furthermore, this study affirms reports a limited number of processing facilities are capable or willing to accept category A waste. Conclusions Developing the proper management of infectious disease materials is essential to close the gaps identified so that states and governmental entities can act accordingly based on the regulations and guidance developed, and to ensure public safety.

In spite of the focus on improving treatment methods and determining the economic and environmental impacts of medical waste management, little research has been conducted to understand consumer perceptions of medical waste reduction. In healthcare setting, our research seeks to address this urgent need by investigating how visual cues can be used to elicit healthcare professionals' willingness to reduce medical plastics. By employing the vignette-based experimental method, we collected data from 1,139 healthcare professionals to examine how visual characteristics (i.e., visual clutter, colorfulness, the presence of human face, the presence of animal) in images of medical plastic pollution were used to arouse moral shock and emotional energy in healthcare professionals. The results of our study suggest that visual displays should be cluttered, colorful, and characterized by human presence. By displaying these visuals in an image of anti-plastic pollution, healthcare professionals are most likely to express their sadness, rage, and despair, and enhance their intention to refuse medical plastics to the fullest extent. By contrast to the previous study, we found that healthcare professionals’ moral shock and willingness to refuse medical plastics were not significantly impacted by the presence of animals on the images.

Coronavirus disease 2019 (COVID-19) is not only a great matter of concern from a medical and health perspective, but it is a serious threat to the environment in terms of waste generated during the prevention and cure of COVID-19. The world has so far compromised more than 3 million human lives, and millions are being infected. Environmental threat is most serious because it can cause secondary complications. As per our knowledge, the amount of waste generated during the pandemic and its estimated quantity has not been assessed, thereby keeping the scientific community, Government authorities and public ignorant of its adverse effects. In this context, we have evaluated the waste generated by the Kingdom of Bahrain, estimated to be 35.480 kg/day (face masks), 1894 kg/day (PPEs) by the selected health facilities, 16,633.505 kg (vaccination-related) and 53,551.240 kg (related to tests conducted so far) in the Kingdom of Bahrain., Graphical abstract Unlabelled Image

Objectives This study aims to examine medical waste management (MWM) practices and identify the challenges of optimal MWM at the primary healthcare (PHC) level in Kebbi State, Nigeria. Study design This study was a cross-sectional survey of 265 primary healthcare workers (PHCWs) and health facilities (HFs) in Kebbi State. Methods The study tool used was a questionnaire adapted from the WHO rapid assessment tool on MWM and water sanitation. Descriptive and inferential statistical analyses were conducted using SPSS version 20 software. Results Data generated from 257 HWs were used in this study. Amidst other findings, only 65 (25%) HFs had MWM guideline or policy document; out of these 65HFs, only 19 (7%) of them had problem with its implementation. Only 42 (16%) HFs had a compensation package or a health insurance policy to take care of their health workers in case of MWM-associated hazards while 22 (9%) HFs had specific budgetary allocation for MWM. Only 105 (41%) HFs had trained staffers on MWM. Sharps, blood/body fluids and domestic wastes were the top three (3) wastes generated among the surveyed HFs. Medical waste treatment was on-site in 124 (48%) HFs and burn-and-bury method was the adopted method of medical waste disposal in 198 (77%) HFs. However, the majority (76%) of the surveyed HWs expressed dissatisfaction about the waste treatment practices adopted in their HFs. Conclusion Our study revealed a poor level of MWM practices in Kebbi State, Nigeria. The state government and partners need to urgently address the identified operational and policy gaps in MWM in Kebbi State, Nigeria. Furthermore, our study revealed the negative implication of fragmented governance and leadership structure at the PHC level on policy, practice and administration of medical waste management in the Kebbi State, Northwestern Nigeria. Addressing the gaps found in this study would contribute to the attainment of the United Nations Sustainable Development Goals in health and well-being, sustainable cities and communities and contribute to poverty eradication.

Study Objective To produce a Stainless-Steel surgical degree tip and attachment that works with uterine manipulator and allows the use of cervical cup for different types of surgeries. - Plastic pollution continue to be a serious problem for human health and environment, it's estimate that for 2030, 53 million tonnes of plastic could end up in rivers, lakes and oceans. One example of how changing consumption patterns can improve the environment is the use and disposal of plastics. The global theme of World Environment Day is “Beat Plastic Pollution”. It aims to change consumer behaviour with the challenge, “If you can't reuse it, refuse it.” In OR we don't have exception, for reducing Medical Waste and optimizing our ORs for the future, we design a stainless-steel surgical degree tip and attachment for the uterine manipulator. Design We produce a 3-D Model plastic tip as a prototype, subsequently a stainless-steel tip and attachment Setting Like it adapts to a uterine manipulator, patient position is lithotomy, the Tip attaches by a "ring" then allows the use of a cervical cup that adapts to the ring. Patients or Participants N/A. Interventions N/A. Measurements and Main Results The design patent pending through the School of Medicine and Engineer, attach to the three types of uterine manipulator also it allows to use the cervical cup and provides the ability to use it in hysterectomy or other procedures without the cervical cup. Base on this we present the prototype guide and assemble. Conclusion The reestirilization of the tip allows us not promote the use of plastic waste.

In addition to the increasing population and rapid urbanization, the amount and variety of medical waste are rapidly increasing due to the coronavirus disease (COVID-19) pandemic affecting the whole world. COVID-19 does not only increase the amount of medical waste produced, medical wastes generated in the care of COVID-19 carries a high risk of transmission as well. In this regard, the safe and effective management of medical wastes has become a serious health and safety issue. This research aims to determine the safest and shortest transportation routes for medical waste vehicles. The safety scores used in this study were obtained in our previous study. The resulting safety scores were used in a multi-objective traveling salesman problem for deriving two objective functions, which are based on safety scores and total transportation distance. A conciliating solution was obtained by solving this linear programming model. The proposed model faced by health institutions in Istanbul has been applied for a specific district. According to the obtained results, suggestions for the direction of medical waste vehicles have been proposed. In addition to the increasing population and rapid urbanization, the amount and variety of medical waste are rapidly increasing due to the coronavirus disease (COVID-19) pandemic affecting the whole world. COVID-19 does not only increase the amount of medical waste produced, medical wastes generated in the care of COVID-19 carries a high risk of transmission as well. In this regard, the safe and effective management of medical wastes has become a serious health and safety issue. This research aims to determine the safest and shortest transportation routes for medical waste vehicles. The safety scores used in this study were obtained in our previous study. The resulting safety scores were used in a multi-objective traveling salesman problem for deriving two objective functions, which are based on safety scores and total transportation distance. A conciliating solution was obtained by solving this linear programming model. The proposed model faced by health institutions in Istanbul has been applied for a specific district. According to the obtained results, suggestions for the direction of medical waste vehicles have been proposed.

The global pandemic caused by the 2019 coronavirus (COVID-19) has led to a dramatic increase in medical waste worldwide. This tremendous increase in medical waste is an important transmission medium for the virus and thus poses new and serious challenges to urban medical waste management. This study investigates the response of medical waste management to the COVID-19 pandemic and subsequent changes in Wuhan City based on the most detailed data available, including waste generation, storage, transportation, and disposal. The results show that despite a 5-fold increase in the demand for daily medical waste disposal in the peak period, the quick responses in the storage, transportation, and disposal sectors during the pandemic ensured that all medical waste was disposed of within 24 hours of generation. Furthermore, this paper discusses medical waste management during future emergencies in Wuhan. The ability of the medical waste management system in Wuhan to successfully cope with the rapid increase in medical waste caused by major public health emergencies has important implications for other cities suffering from the pandemic and demonstrates the need to establish resilient medical emergency systems in urban areas.

COVID-19 has led to the enormous rise of medical wastes throughout the world, and these have mainly been generated from hospitals, clinics, and other healthcare establishments. This creates an additional challenge in medical waste management, particularly in developing countries. Improper managing of medical waste may have serious public health issues and a significant impact on the environment. There are currently three disinfection technologies, namely incineration, chemical, and physical, that are available to treat COVID-19 medical waste (CMW). This study focuses on thermochemical process, particularly the pyrolysis process to treat medical waste. Pyrolysis is a process that utilizes the instability of organic components in medical waste to convert it into valuable products. Besides, the technique is environmentally friendly, more efficient, requires less landfill capacity, causes lower pollution, and cost-effective. The current pandemic situation generates a high amount of plastic medical waste, which has components like polyethylene (PE), polypropylene (PP), polystyrene (PS), polyethylene terephthalate (PET) and nylon (N). These plastic wastes can be converted into valuable energy products like oil, gas and char through the pyrolysis process. This study provides detailed information about CMW handling, treatments, valuable product generations (biofuels), and proper discharge into the open environment., Graphical abstract Image 1

The COVID-19 pandemic has exerted great shocks and challenges to the environment, society and economy. Simultaneously, an intractable issue appeared: a considerable number of hazardous medical wastes have been generated from the hospitals, clinics, and other health care facilities, constituting a serious threat to public health and environmental sustainability without proper management. Traditional disposal methods like incineration, landfill and autoclaving are unable to reduce environmental burden due to the issues such as toxic gas release, large land occupation, and unsustainability. While the application of clean and safe pyrolysis technology on the medical wastes treatment to produce high-grade bioproducts has the potential to alleviate the situation. Besides, medical wastes are excellent and ideal raw materials, which possess high hydrogen, carbon content and heating value. Consequently, pyrolysis of medical wastes can deal with wastes and generate valuable products like bio-oil and biochar. Consequently, this paper presents a critical and comprehensive review of the pyrolysis of medical wastes. It demonstrates the feasibility of pyrolysis, which mainly includes pyrolysis characteristics, product properties, related problems, the prospects and future challenges of pyrolysis of medical wastes.

Waste Incinerators and waste-to-energy (WTE) plants are viable sources to compensate for the energy (thermal/heat and electricity) requirements, especially in developing countries which are facing shortage of energy. However due to highly corrosive waste these plants are running at low temperature and hence at low efficiency. Since there is no possibility of removal or selection of corrosive waste/fuel as the waste management/disposal is the primary requirement of these plants, therefore in this study efforts are made for comparative performance study of new materials to raise the working temperature of these plants. The present study was planned to test uncoated/bare N06601 superalloy and the effect of surface modification (50%Ni-50%Cr) by cold spray process in the real service medical waste based incinerator environment at 900 °C for 1000 h. The performance has been characterized via surface morphology, phase composition and element concentration using the combined techniques of XRD, SEM/EDX, BSEI and Elemental X-Ray analysis. The chlorine based incinerator environment is found to be so aggressive that corrosive species are able to penetrate through the N06601superalloy specially designed for high temperature applications. Highly corrosive ‘Active-Oxidation’ reaction mechanism is observed in the case of bare alloy, which is not observed in modified alloy.

Incinerators have been widely used to burn the medical waste at very high temperature. The temperature combined with the aggressive species damage the components used in the construction. In the present study Cr 3 C 2 -NiCr coated superalloys Superni 718, Superni 600 and Superco 605 have been tested under actual medical waste incinerator environment. The coated specimens were exposed for 1000 h in the secondary chamber of the incinerator. Results showed that coated Superni 718 and Superni 600 performed satisfactorily under the corrosive atmosphere whereas coating was partially delaminated from Superco 605.

Amniotic fluid (AF) is now known to harbor highly potent stem cells, making it an excellent source for cell therapy. However, most of the stem cells isolated are from AF of mid-term pregnancies in which the collection procedure involves an invasive technique termed amniocentesis. This has limited the access in getting the fluid as the technique imposes certain level of risks to the mother as well as to the fetus. Alternatively, getting AF from full-term pregnancies or during deliveries would be a better resolution. Unfortunately, very few studies have isolated stem cells from AF at this stage of gestation, the fluid that is merely discarded during delivery. The question remains whether full-term AF harbors stem cells of similar potency as of the stem cells of mid-term AF. Here, we aim to review the prospect of having this type of stem cells by first looking at the origin and contents of AF particularly during different gestation period. We will then discuss the possibility that the AF, at full term, contains a population of highly potent stem cells. These stem cells are distinct from, and probably more potent than the AF mesenchymal stem cells (AF-MSCs) isolated from full-term AF. By comparing the studies on stem cells isolated from mid-term versus full-term AF from various species, we intend to address the prospect of having highly potent amniotic fluid stem cells from AF of full-term pregnancies in human and animals.

A study on the generation rate and the composition of solid medical wastes (MW) produced by private medical microbiology laboratories (PMML) was conducted in Greece. The novelty of the work is that no such information exists in the literature for this type of laboratories worldwide. Seven laboratories were selected with capacities that ranged from 8 to 88 examinees per day. The study lasted 6months and daily recording of MW weights was done over 30days during that period. The rates were correlated to the number of examinees, examinations and personnel. Results indicated that on average 35% of the total MW was hazardous (infectious) medical wastes (IFMW). The IFMW generation rates ranged from 11.5 to 32.5g examinee-1 d-1 while an average value from all 7 labs was 19.6±9.6g examinee-1 d-1 or 2.27±1.11g examination-1 d-1. The average urban type medical waste generation rate was 44.2±32.5g examinee-1 d-1. Using basic regression modeling, it was shown that the number of examinees and examinations can be predictors of the IFMW generation, but not of the urban type MW generation. The number of examinations was a better predictor of the MW amounts than the number of examinees. Statistical comparison of the means of the 7PMML was done with standard ANOVA techniques after checking the normality of the data and after doing the appropriate transformations. Based on the results of this work, it is approximated that 580 tonnes of infectious MW are generated annually by the PMML in Greece.

We describe a chromatographic approach for the purification of urinary free light chains (FLCs) viz., lambda free light chains (λ-FLCs) and kappa free light chains (κ-FLCs). Isolated urinary FLCs were analyzed by SDS-PAGE, immunoblotting and mass spectrometry (MS). The relative molecular masses of λ-FLC and κ-FLC are 22,933.397 and 23,544.336Da respectively. Moreover, dimer forms of each FLC were also detected in mass spectrum which corresponds to 45,737.747 and 47,348.028Da respectively for λ-FLCs and κ-FLCs. Peptide mass fingerprint analysis of the purified λ-FLCs and κ-FLCs has yielded peptides that partially match with known light chain sequences viz., gi|218783338 and gi|48475432 respectively. The tryptic digestion profile of isolated FLCs infers the exclusive nature of them and they may be additive molecules in the dictionary of urinary proteins. This is the first report of characterization and validation of FLCs from large volume samples by peptide sequencing. This simple and cost-effective approach to purification of FLCs, together with the easy availability of urine samples make the large-scale production of FLCs possible, allowing exploration of various bioclinical as well as biodiagnostic applications.

Emission characteristic of polychlorinated dibenzo-p-dioxins and polychlorinated dibenzofurans (PCDD/Fs) from 12 medical waste incinerators (MWIs) which have a total yearly capacity of 523 440 ton medical waste and accounted for 8.1% of total yearly capacity of 246 MWIs in China were studied. The congeners profile, emissions and toxic equivalent concentrations (TEQ) indicators of PCDD/Fs in stack gas from two groups of MWIs were researched, and the possible formation mechanisms of PCDD/Fs from MWIs were preliminarily discussed. The results of present study were summarized as follows. (1) The total concentrations and TEQ of PCDD/Fs in stack gas from MWIs were 0.516-122.803 ng Nm-3 and 0.031-3.463 ng I-TEQ Nm-3, respectively. (2) 1,2,3,4,6,7,8-H7CDF, O8CDD, O8CDF and 1,2,3,4,6,7,8-H7CDD were the indicatory PCDD/Fs of MWI source, which could be used to apportion the sources of PCDD/Fs in environmental medium in China. (3) The emission factors of PCDD/Fs from MWIs ranged from 32.7 to 4900.0 ng I-TEQ ton-1 with a mean of 1923.6 ng I-TEQ ton-1. (4) The gas emissions of PCDD/Fs from researched 12 MWIs and all of MWIs in China in 2016 were 37.742 and 465.951 mg I-TEQ year-1, respectively. (5) 1,2,3,7,8,9-H6CDF and 1,2,3,4,7,8-H6CDF were effective TEQ indicators for the real-time monitoring of the PCDD/Fs emission. (6) The congeners profile and factor composition of PCDD/Fs in stack gas from two groups of MWIs were researched based on positive matrix factorization (PMF) model, and the possible formation mechanisms of PCDD/Fs from MWIs were preliminarily discussed.

Health-care waste management requires technical, financial and human resources, and it is a challenge for low- and middle income countries, while it is often neglected in protracted crisis or emergency situations. Indeed, when health, safety, security or wellbeing of a community is threatened, solid waste management usually receives limited attention. Using the Gaza Strip as the case study region, this manuscript reports on health-care waste management within the context of a humanitarian crisis. The study employed a range of methods including content analyses of policies and legislation, audits of waste arisings, field visits, stakeholder interviews and evaluation of treatment systems. The study estimated a production from clinics and hospitals of 683 kg/day of hazardous waste in the Gaza Strip, while the total health-care waste production was 3357 kg/day. A number of challenges was identified including lack of clear definitions and regulations, limited accurate data on which to base decisions and strategies and poor coordination amongst key stakeholders. Hazardous and non-hazardous waste was partially segregated and treatment facilities hardly used, and 75% of the hazardous waste was left untreated. Recommendations for mitigating these challenges posed to patients, staff and the community in general are suggested. The outputs are particularly useful to support decision makers, and re-organize the system according to reliable data and sound assumptions. The methodology can be replicated in other humanitarian settings, also to other waste flows, and other sectors of environmental sanitation.

Medical waste is a special class of hazardous pollutants. Improper treatment would cause secondary environmental pollution, especially when responding to public health emergencies. However, there are relatively few researches on the generation of medical waste, and there is a lack of basic understanding of its spatial-temporal heterogeneity. The outbreak of SARS in 2002 is a turning point in China’s medical system reform. We estimated the production of medical waste and pollutants on a provincial scale in China from 2002 to 2018, using the data of medical statistics. Moreover, we forecasted the trend of medical waste in China until 2030, using a combination of environmental pressure model (STIRPAT) and time series model (ARIMA). We found that with the development of China’s medical system and economy (such as the increase in personal income and popularization of universal health care), the number of seeking medical treatment rapidly increase led to explosive growth in medical waste (∼240%) and pollutants (∼260%), and large hospitals are the major sources. By 2030, the production of medical waste would still increase by more than 50% compared with 2018 even there is no the pandemic due to the huge population. The production of medical waste in the eastern region was higher than that in the west under the influence of higher population and GDP, while the per capita medical waste was only affected by household consumption level which had no regional characteristic. Additionally, Hg loads from medical waste are more than twice as high as that from discharged wastewater in some regions, which are facing great control pressures. In the future, when planning for medical waste disposal, policymakers shall increase the disposal facilities based on population and promote mobile treatment equipment to improve efficiency, increase the number of beds in medical institutions rather than building more hospitals, and strengthen basic research on the environmental impact., Highlights • Medical waste grows rapidly in China since the outbreak of SARS. • Regional economy level significantly affects the total output of medical waste. • Household consumption level significantly affects medical waste per capita. • China will face huge pressure on the growth of medical waste in the next decade.

Highlights • COVID-19 pandemic brought huge amount of medical wastes, which is mainly made of plastic polymer. • Thermochemical treatments (incineration, torrefaction, pyrolysis, and gasification) are reviewed. • The review focuses on the applicability of those technologies to convert the medical wastes. • Incineration has the highest material flexibility, followed by gasification and pyrolysis. • Gasification and pyrolysis are considered as the most promising conversion technologies., COVID-19 pandemic has brought tremendous environmental burden due to huge amount of medical wastes (about 54,000 t/d as of November 22, 2020), including face mask, gloves, clothes, goggles, and sanitizer/disinfectant containers. A proper waste management is urgently required to mitigate the spread of the disease, minimize the environmental impacts, and take their potential advantages for further utilization. This work provides a prospective review on the possible thermochemical treatments for those COVID-19 related medical wastes (CMW), as well as their possible conversion to fuels. The characteristics of each waste are initially analyzed and described, especially their potential as energy source. It is clear that most of CMWs are dominated by plastic polymers. Thermochemical processes, including incineration, torrefaction, pyrolysis, and gasification, are reviewed in terms of applicability for CMW. In addition, the mechanical treatment of CMW into sanitized refuse-derived fuel (SRDF) is also discussed as the preliminary stage before thermochemical conversion. In terms of material flexibility, incineration is practically applicable for all types of CMW, although it has the highest potential to emit the largest amount of CO2 and other harmful gasses. Furthermore, gasification and pyrolysis are considered promising in terms of energy conversion efficiency and environmental impacts. On the other hand, carbonization faces several technical problems following thermal degradation due to insufficient operating temperature., Graphical abstract Image, graphical abstract

Countries with abundant solar radiation have the potential to invest in simple technologies for deactivation of many bacteria and viruses in medical solid waste. In addition to the traditional Infection and Prevention Control (IPC) measures, these simple technologies contribute to better protection of health care workers in countries with compromised solid management schemes. Monitoring of temperature, relative humidity and ultraviolet inside containers soundly designed to collect disposal infectious waste illustrated to deactivate several viruses and bacteria. Casanova et al., 2010, used some surrogate viruses to overcome the challenges of working with SARS-CoV, concluded that by temperature above 40 °C most of viruses become below levels of detection after 90 min. Here we are proposing a model of a simple transparent container almost 200 L in volume that allow solar energy to be accumulated inside. In summer conditions in the testing site, temperature inside the container reached above 50 °C when the ambient air temperature was around 30 °C. The container was built using epoxy glass to guarantee maximum heat penetration. Actual temperature measurement inside the container was measured in real time against ambient air temperature. We present a mathematical model for predication of maximum temperature at different positions inside the container and their relation to different ambient air temperature scenarios. The mathematical formulas used are based on the conservation laws and a good agreement of a full month of field measurements were obtained. Even in winter conditions in many of developing countries air temperature can maintain levels above 20 °C, which will produce temperature around 30 °C and viruses can reach levels below detection limit in maximum 3 h.

Graphical abstract, Highlights • COVID-19 hazardous waste amount of different countries is provided. • New emergence of “PPE pollution” is observed in the world’s seas and oceans. • Industrial furnaces, cement and brick kilns can be used as alternative incinerator facilities. • Waste management will be a challenging issue in the post pandemic period., The COVID-19 pandemic and lockdown situation have shown both positive and negative effects on the environmental aspects. With an unprecedented rate the different types of waste volume have up surged along with the COVID-19 contamination rate. As the situation has mandated people as well as the most infected persons to stay at home, the amount of generated hazardous waste is 3.40 kg that can be expected daily from each infected person. China and other countries have seen a massive increment in the hazardous waste generation (about 600 % increase in Hubei province) amount. While dealing with this sudden increase in waste amount, the conventional incineration facilities have been outstripped and waste management industry is facing an immense pressure over handling hazardous waste generated from COVID-19 infected patients. Alongside with the hazardous waste volume, single-use plastic items and personal protective equipment (PPEs) have induced a new type of “PPE pollution” in the land and aquatic environment. The current review provides a countrywide waste generation amount, estimated using the infected number of cases for some selected countries. In contrast with the poor waste management noticed during this pandemic, some suggested approaches towards a better waste management service and future implications of waste management are discussed with viable consideration for the waste workers.

Low-level radioactive waste is the inevitable outcome of many industrial, medical applications and nuclear power plants. This type of low-level waste is, however, also very hazardous, and its proper disposal is necessary as it may leak and contaminate soil and water, leading to both the environment and human health issues. The disposition and storage of the radioactive waste in its original form is very much critical and expensive, hence the pre-processing, including the proper procedure for the storage allocation is necessary for effective handling of this waste disposal. Most common approaches of preprocessing are “replace,” “reduce,” “reuse,” and “recycle.” The “reduce” approach is explored in this study using the novel microwave technology to handle the low-level radioactive waste. This approach has never been used before for this purpose. The applicability of the proposed method is validated using medical waste such as tissue papers, plastic carry bags, etc., and industrial waste such as Teflon tubing, concrete, glass, wood, etc., as test objects. These test objects (waste materials) are first categorized here based on their dielectric loss in order to explore the possibility of heating them using either the microwave or the conventional heating process. The heating process can effectively reduce total waste volume in a short span of time. The categorization of these materials is carried out by placing them into the prototype concealed environment to avoid any radioactive leakage. Finally, microwave technology is actually applied for the first time to monitor the online reduction in the volume of waste during the treatment processes.

This studystudy focuses on the effect of radiation treatment and hydrogen peroxide (H2O2) on the toxicity of anticancer methotrexate. For cytotoxicity, different bioassays such as Allium cepa, hemolytic, brine shrimp were employed. The Ames test was used for mutagenicity analysis. The solutions having concentrations 5, 10 and 15 ppm were irradiated with UV radiation exposure time 15, 30, 45, 60, 75 and 90 min and gamma radiation absorbed doses 0.3, 0.6, 0.9, 1.2, 2, 3 and 4 kGy in combination with with H2O2. There was a clear difference observed for aqueous solution before and after treatment with reference to cytotoxicity and mutagenicity. In Allium cepa test, a 47.07, 44.36 and 38.23% increase in root length (RL), root count (RC) and mitotic index (MI) was observed, respectively, for UV/H2O2 treatment and in the case of gamma/H2O2 treatment, the RL, RC and MI were increased up to 49.39, 52.63 and 52.38%, respectively. Brine shrimp test has shown 85.95 and 91.30% decrease in toxicity using UV/H2O2 and gamma/H2O2 respectively, while hemolytic test has shown 19.21 and 26.32% hemolysis using UV/H2O2 and gamma/H2O2, respectively. The mutagenicity reduced up to 82.3, 86.46 and 89.59% (TA98) and 85.42, 87.5 and 90.63% (TA100) for UV/H2O2 while 89.59, 90.63 and 93.75% (TA98) and 84.38, 89.59 and 92.71% (TA100) for gamma/H2O2. The UV and gamma radiation along with H2O2 based AOPs are promising approaches to detoxify the wastewater which can be extended to real hospital liquid effluent effectively.

Rationale and Objectives The increasing use of imaging in the emergency department (ED) services has become an important problem on the basis of cost and unnecessary exposure to radiation. Radiographic examination of the chest has been reported to be performed in 34.4% of ED visits, and chest computerized tomography (CCT) in 15.8%, whereas some patients receive both chest radiography and CCT in the same visit. In the current study, it was aimed to establish instances of medical waste and unnecessary radiation exposure and to show how the inclusion of radiologists in the ordering process would affect the amount of unnecessary imaging studies. Materials and Methods This retrospective study included 1012 ED patients who had both chest radiography and CCT during the same visit at Ankara Training and Research Hospital between April 2015 and January 2016. The patients were divided into subgroups of trauma and nontrauma. To detect unnecessary imaging examinations, data were analyzed according to the presence of additional findings on CCT images and the recommendation of a radiologist for CCT imaging. Results In the trauma group, 77.1% (461/598) and in the nontrauma group, 80.4% (334/414) of patients could be treated without any need for CCT. In the trauma group, the radiologist recommendation only, and in the nontrauma group, both the radiologist recommendation and the age were determined to be able to predict the risk of having additional findings on CCT. Conclusions Considering only the age of the patient before ordering CCT could decrease the rate of unnecessary imaging. Including radiologists into both the evaluation and the ordering processes may help to save resources and decrease exposure to ionizing radiation.

In the present study, three superalloys viz. Superni 718, Superni 600 and Superco 605 were hung inside the secondary chamber of actual medical waste incinerator where the temperature is more than 1050 °C. Burning of medical waste produces very corrosive environment at high temperature which can degrade the components of construction. Hence the three superalloys were kept for 1000 h inside the chamber. Corrosion rate has been calculated in mpy. Corrosion products so produced were characterized using SEM/EDS and XRD technique. It was observed that both the Nickel based superalloys showed better corrosion resistance than the cobalt based superalloy under the given environment.

Most surgeons equate environmentalism with the softer sciences related more to personal philosophy than with anything connected to the harder science and business of healing patients. Only after we can get beyond the jokes about “saving whales” and “hugging trees” and “going green,” canwe truly appreciate environmentalism in surgery for what it is: a smart, efficient, and cost effective way to do business in 2016. In the past decade, and especially in the wake of the Affordable Care Act, there has been national emphasis on improving the quality of health care delivery and increasing transparency while decreasing cost. Ironically, this is happening at a time when rapidly evolving technology is making health care more and more expensive. By evaluating the current system and eliminating waste and unnecessary expense, providers and health care systems can achieve that balance between quality and affordability. When waste accounts for at least 20% of health care costs, the current system of tight operating margins and hypersensitive awareness to expense is bound to fail. Medicare and Medicaid estimates that health care spending is growing at a rate of 1.1% per year (faster than Gross Domestic Product [GDP] itself). By 2024, it would account for 19.6% of GDP. Overall, 60% of all hospital costs are accrued in the operating room (OR). Surgeons are stewards of the medical profession and leaders, not just in the OR, but in their communities as well. As such, it is the surgeon’s obligation to proactively address the issues of quality and cost at the same time as environmental concerns such as global warming, landfill burden, toxic waste disposal, and limited and dwindling precious resources. Luckily for surgeons, these issues are