Advancing interdisciplinary science for disrupting wildlife trafficking networks.

Wildlife trafficking, whether local or transnational in scope, undermines sustainable development efforts, degrades cultural resources, endangers species, erodes the local and global economy, and facilitates the spread of zoonotic diseases. Wildlife trafficking networks (WTNs) occupy a unique gray space in supply chains-straddling licit and illicit networks, supporting legitimate and criminal workforces, and often demonstrating high resilience in their sourcing flexibility and adaptability. Authorities in different sectors desire, but frequently lack knowledge about how to allocate resources to disrupt illicit wildlife supply networks and prevent negative collateral impacts. Novel conceptualizations and a deeper scientific understanding of WTN structures are needed to help unravel the dynamics of interaction between disruption and resilience while accommodating socioenvironmental context. We use the case of ploughshare tortoise trafficking to help illustrate the potential of key advancements in interdisciplinary thinking. Insights herein suggest a significant need and opportunity for scientists to generate new science-based recommendations for WTN-related data collection and analysis for supply chain visibility, shifts in illicit supply chain dominance, network resilience, or limits of the supplier base.

Presenting a mathematical model of blood supply chain considering the efficiency of collection centers and development of metaheuristic algorithm in M/M/C/K queuing system.

In this study, a multiobjective model was devoted to the objectives of minimizing blood supply chain costs and minimizing the waiting time of blood donors for blood transfusion and minimizing blood transfusion schedule and increasing the efficiency of fixed and mobile centers in collecting blood. One of the most important constraints considered in the mathematical model is the capacity constraints of considering fixed and mobile blood facilities and management of the transfer of blood products to centers for collecting and distinguishing healthy and unhealthy blood. A multiobjective model was considered with the objectives of minimizing blood supply chain costs, the waiting time of blood donors for blood transfusion, and blood transfusion timing and increasing the efficiency of fixed and mobile centers in blood collection. The model findings were analyzed in order to validate the model on a larger scale, using the meta-innovative algorithm NSGAII and MOSPO. According to the research findings, we suggest that fuzzy uncertainty and fair distribution problem shouldn't be added to the dimensions of the main problem, and further analysis should be done in this area. It was shown that the NSGAII algorithm's performance was better than the MOPSO meta-heuristic algorithm.

From the laboratory to the consumer: Innovation, supply chain, and adoption with applications to natural resources.

We analyze the transition from innovative ideas to final marketed products. This transition occurs through two synergetic supply chains for innovation and products. Basic concepts are developed, tested, upscaled, and introduced to commercial use in the innovation supply chain. Then, the products are produced and delivered to the consumer through the product supply chain. We argue that product markets trace their birth to product innovations. These markets tend to start as noncompetitive, which rewards innovators. Credit access and risk determine the reliance on contracting and product diffusion over space and time. The innovation and product supply chains are encouraged and facilitated by public policies, such as support for research and education, intellectual property rights protection, low barriers to trade, science-based regulation, and well-functioning capital markets. We argue for multidisciplinary research incorporating knowledge from economics, business, and engineering to better understand the evolution of innovative companies and supply chains. This understanding will help the development of policies to address challenges of climate change and food security among others.

Expanding community case management of malaria to all ages can improve universal access to malaria diagnosis and treatment: results from a cluster randomized trial in Madagascar.

BACKGROUND: Global progress on malaria control has stalled recently, partly due to challenges in universal access to malaria diagnosis and treatment. Community health workers (CHWs) can play a key role in improving access to malaria care for children under 5 years (CU5), but national policies rarely permit them to treat older individuals. We conducted a two-arm cluster randomized trial in rural Madagascar to assess the impact of expanding malaria community case management (mCCM) to all ages on health care access and use. METHODS: Thirty health centers and their associated CHWs in Farafangana District were randomized 1:1 to mCCM for all ages (intervention) or mCCM for CU5 only (control). Both arms were supported with CHW trainings on malaria case management, community sensitization on free malaria care, monthly supervision of CHWs, and reinforcement of the malaria supply chain. Cross-sectional household surveys in approximately 1600 households were conducted at baseline (Nov-Dec 2019) and endline (Nov-Dec 2021). Monthly data were collected from health center and CHW registers for 36 months (2019-2021). Intervention impact was assessed via difference-in-differences analyses for survey data and interrupted time-series analyses for health system data. RESULTS: Rates of care-seeking for fever and malaria diagnosis nearly tripled in both arms (from less than 25% to over 60%), driven mostly by increases in CHW care. Age-expanded mCCM yielded additional improvements for individuals over 5 years in the intervention arm (rate ratio for RDTs done in 6-13-year-olds, RRRDT6-13 years = 1.65; 95% CIs 1.45-1.87), but increases were significant only in health system data analyses. Age-expanded mCCM was associated with larger increases for populations living further from health centers (RRRDT6-13 years = 1.21 per km; 95% CIs 1.19-1.23). CONCLUSIONS: Expanding mCCM to all ages can improve universal access to malaria diagnosis and treatment. In addition, strengthening supply chain systems can achieve significant improvements even in the absence of age-expanded mCCM. TRIAL REGISTRATION: The trial was registered at the Pan-African Clinical Trials Registry (#PACTR202001907367187).

Carbon footprint of synthetic nitrogen under staple crops: A first cradle-to-grave analysis.

More than half of the world's population is nourished by crops fertilized with synthetic nitrogen (N) fertilizers. However, N fertilization is a major source of anthropogenic emissions, augmenting the carbon footprint (CF). To date, no global quantification of the CF induced by N fertilization of the main grain crops has been performed, and quantifications at the national scale have neglected the CO2 assimilated by plants. A first cradle-to-grave life cycle assessment was performed to quantify the CF of the N fertilizers' production, transportation, and application to the field and the uses of the produced biomass in livestock feed and human food, as well as biofuel production. We quantified the direct and indirect inventories emitted or sequestered by N fertilization of main grain crops: wheat, maize, and rice. Grain food produced with N fertilization had a net CF of 7.4 Gt CO2eq. in 2019 after excluding the assimilated C in plant biomass, which accounted for a quarter of the total CF. The cradle (fertilizer production and transportation), gate (fertilizer application, and soil and plant systems), and grave (feed, food, biofuel, and losses) stages contributed to the CF by 2%, 11%, and 87%, respectively. Although Asia was the top grain producer, North America contributed 38% of the CF due to the greatest CF of the grave stage (2.5 Gt CO2eq.). The CF of grain crops will increase to 21.2 Gt CO2eq. in 2100, driven by the rise in N fertilization to meet the growing food demand without actions to stop the decline in N use efficiency. To meet the targets of climate change, we introduced an ambitious mitigation strategy, including the improvement of N agronomic efficiency (6% average target for the three crops) and manufacturing technology, reducing food losses, and global conversion to healthy diets, whereby the CF can be reduced to 5.6 Gt CO2eq. in 2100.

Extensive red blood cell matching considering patient alloimmunization risk.

BACKGROUND AND OBJECTIVES: Red blood cell (RBC) transfusions pose a risk of alloantibody development in patients. For patients with increased alloimmunization risk, extended preventive matching is advised, encompassing not only the ABO-D blood groups but also the most clinically relevant minor antigens: C, c, E, e, K, Fya, Fyb, Jka, Jkb, S and s. This study incorporates patient-specific data and the clinical consequences of mismatching into the allocation process. MATERIALS AND METHODS: We have redefined the MINimize Relative Alloimmunization Risks (MINRAR) model to include patient group preferences in selecting RBC units from a finite supply. A linear optimization approach was employed, considering both antigen immunogenicity and the clinical impact of mismatches for specific patient groups. We also explore the advantages of informing the blood bank about scheduled transfusions, allowing for a more strategic blood distribution. The model is evaluated using historical data from two Dutch hospitals, measuring shortages and minor antigen mismatches. RESULTS: The updated model, emphasizing patient group-specific considerations, achieves a similar number of mismatches as the original, yet shifts mismatches among patient groups and antigens, reducing expected alloimmunization consequences. Simultaneous matching for multiple hospitals at the distribution centre level, considering scheduled demands, led to a 30% decrease in mismatches and a 92% reduction in shortages. CONCLUSION: The reduction of expected alloimmunization consequences by incorporating patient group preferences demonstrates our strategy's effectiveness for patient health. Substantial reductions in mismatches and shortages with multi-hospital collaboration highlights the importance of sharing information in the blood supply chain.

Cultivated alien plants with high invasion potential are more likely to be traded online in China.

Biological invasions have become a worldwide problem, and measures to efficiently prevent and control invasions are still in development. Like many other parts of the world, China is undergoing a dramatic increase in plant invasions. Most of the currently 933 established (i.e., naturalized) plant species, of which 214 are categorized as invasive, have been introduced into China for cultivation. It is likely that many of those species are still being traded, particularly online, by plant nurseries. However, studies assessing whether naturalized and invasive species are currently being traded more or less than nonnaturalized aliens are rare. We extracted online-trade information for 13,718 cultivated alien plant taxa on 1688.com, the largest website for domestic B2B in China. We analyzed how the presence in online-nursery catalogs, the number of online nurseries that offerred the species for sale, and the product type (i.e., seeds, live plants and vegetative organs) differed among nonnaturalized, naturalized noninvasive, and invasive species. Compared to nonnaturalized taxa, naturalized noninvasive and invasive taxa were 3.7-5.2 times more likely to be available for purchase. Naturalized noninvasive and invasive taxa were more frequently offered as seeds by online nurseries, whereas nonnaturalized taxa were more frequently offered as live plants. Based on these findings, we propose that, to reduce the further spread of invasive and potentially invasive plants, implementation of plant-trade regulations and a monitoring system of the online horticultural supply chain will be essential.

Materials Challenges in the Electric Vehicle Transition.

The ongoing transition toward electric vehicles (EVs) is changing materials used for vehicle production, of which the consequences for the environmental performance of EVs are not well understood and managed. We demonstrate that electrification coupled with lightweighting of automobiles will lead to significant changes in the industry's demand not only for battery materials but also for other materials used throughout the entire vehicle. Given the automotive industry's substantial consumption of raw materials, changes in its material demands are expected to trigger volatilities in material prices, consequently impacting the material composition and attractiveness of EVs. In addition, the materials recovered during end-of-life recycling of EVs as the vehicle fleet turns over will impact recycled material supplies both positively and negatively, impacting material availabilities and the economic incentive to engage in recycling. These supply chain impacts will influence material usage and the associated environmental performance of not only the automotive sector but also other metal-heavy industries such as construction. In light of these challenges, we propose the need for new research to understand the dynamic materials impacts of the EV transition that encompasses its implications on EV adoption and fleet life cycle environmental performance. Effectively coordinating the coevolution of material supply chains is crucial for making the sustainable transition to EVs a reality.

Wasted Food, Wasted Resources? A Critical Review of Environmental Impact Analysis of Food Loss and Waste Generation and Treatment.

Food loss and waste (FLW) comes with significant environmental impacts and thus prevents a sustainable food system transition. Here we conducted a systematic review of 174 screened studies that assessed the environmental impacts of FLW generation and treatment. We found that the embodied impacts of FLW along the supply chain and impacts from FLW treatment received equal attention, but few studies have included both. The reviewed studies show narrow geographical (mostly conducted in industrialized countries) and food supply chain (mostly focused on the consumption stage) coverage. Life cycle analysis (LCA), material flow analysis (MFA), or their combination are the most commonly used to quantify FLW related environmental impacts. More method standardization, integration, and innovation and better FLW data with regional and stage resolution from a first-hand source are badly needed. Among the various proposed mitigation strategies covering technology, economy, behavior, and policy aspects, process optimization and waste management options are the most discussed. Our review calls for a more holistic environmental impact assessment of FLW generation and treatment and analysis of the trade-offs among different environmental impact categories and between supply chain stages, which would better inform relevant policy on effective environmental impact mitigation strategies toward sustainable food systems.

Landscape-Scale Biodiversity Impacts Analysis of Côte d'Ivoire's Cocoa Cultivation along Export Supply Chains.

Agricultural land use for export commodities leads to significant biodiversity impacts. A spatially detailed assessment of these impacts is crucial for implementing effective mitigation policies. Using cocoa cultivation and exports in Côte d'Ivoire as an example, we present a novel framework that combines earth observations, enhanced landscape-scale biodiversity models, and subnational export supply chain data sets to track the tele-connected potential biodiversity impacts of export groups and importing countries. We found that cocoa cultivation accounts for ∼44% of the biodiversity impacts in Côte d'Ivoire's cocoa cultivation areas, with >90% attributable to cocoa exports. The top 10 importing countries account for ∼84% of these impacts. Our method offers improved spatial detail compared to the existing approaches, facilitating the identification of biodiversity impact hotspots. Additionally, the biodiversity impacts of agroforestry cocoa are not always lower compared to full-sun cocoa, especially when agroforestry systems are established in regions of high biodiversity importance. Our transferable framework provides a comprehensive understanding of biodiversity footprint and promotes informed decision-making for sustainable agricultural production, processing, and trade. Our framework's application is currently constrained by the scarcity of detailed supply chain data sets; we underscore the urgent need for improved supply chain transparency to fully unlock the framework's potential.

Evaluating Losses from Water Scarcity and Benefits of Water Conservation Measures to Intercity Supply Chains in China.

The severe water scarcity in China poses significant economic risks to its agriculture, energy, and manufacturing sectors, which can have a cascading effect through the supply chains. Current research has assessed water scarcity losses for global countries and Chinese provinces by using the water scarcity risk (WSR) method. However, this method involves subjective functions and parameter settings, and it fails to capture the adaptive behaviors of economies to water scarcity, compromising the reliability of quantified water scarcity loss. There is a pressing need for a new method to assess losses related to water scarcity. Here, we develop an agent-based complex network model to estimate the inter-regional and intersectoral impacts of water scarcity on both cities and basins. Subsequently, we evaluate the supply chain-wide economic benefits of four different water conservation measures as stipulated by the 14th Five-Year Plan for the Construction of a Water-Saving Society. These measures include increasing the utilization rate of recycled water in water-scarce cities, reducing the national water consumption per industrial value-added, and implementing agricultural and residential water conservation measures. Results show that direct losses constitute only 9% of the total losses from water scarcity. Approximately 37% of the losses can be attributed to interregional impacts. Among the water-scarce cities, Qingdao, Lanzhou, Jinan, and Zhengzhou pose a significant threat to China's supply chains. Agricultural water conservation yields the highest amount of water savings and economic benefits, while residential water conservation provides the highest economic benefit per unit of water saved. The results provide insights into managing water scarcity, promoting cross-regional cooperation, and mitigating economic impacts.

Achieving Decentralized, Electrified, and Decarbonized Ammonia Production.

The rapid reduction in the cost of renewable energy has motivated the transition from carbon-intensive chemical manufacturing to renewable, electrified, and decarbonized technologies. Although electrified chemical manufacturing technologies differ greatly, the feasibility of each electrified approach is largely related to the energy efficiency and capital cost of the system. Here, we examine the feasibility of ammonia production systems driven by wind and photovoltaic energy. We identify the optimal regions where wind and photovoltaic electricity production may be able to meet the local demand for ammonia-based fertilizers and set technology targets for electrified ammonia production. To compete with the methane-fed Haber-Bosch process, electrified ammonia production must reach energy efficiencies of above 20% for high natural gas prices and 70% for low natural gas prices. To account for growing concerns regarding access to water, geospatial optimization considers water stress caused by new ammonia facilities, and recommendations ensure that the identified regions do not experience an increase in water stress. Reducing water stress by 99% increases costs by only 1.4%. Furthermore, a movement toward a more decentralized ammonia supply chain driven by wind and photovoltaic electricity can reduce the transportation distance for ammonia by up to 76% while increasing production costs by 18%.

A carbon neutral supply chain management by considering emission-risk minimization and green purchasing through optimal decision-making.

This study addresses critical gaps in supply chain management (SCM) by integrating emission-risk minimization (ERM), green purchasing (GP), and profit maximization (PM). The research focuses on the optimal behaviors of manufacturers, agents, and retailers within the SCM framework to achieve carbon neutrality and reduce carbon dioxide emissions (CO2e). This study considers Guangdong province, China, a region facing challenges in optimizing energy systems and meeting CO2e reduction targets. Simulation-based optimization techniques within mathematical models are employed. A design of experiment (DOE) method was used to explore the dynamics of key variables in the SCM environment. Results reveal optimal behaviors for manufacturers, agents, and retailers, demonstrating the ideal values for profit and pricing decisions. Manufacturers optimize production quantity, achieving CO2e reduction and PM through ERM. Agents exhibit a strong commitment to GP practices, enhancing PM and carbon-neutral goals. Retailers get more PM than manufacturers and agents, contributing to a clean environment. Interestingly, retailers make contributions to the clean environment without considering ERM and GP in SCM. The study contributes novel insights by addressing the identified gap in SCM research, emphasizing the joint consideration of ERM, GP, and PM. This research assists manufacturers, agents, and retailers in terms of PM for economic objectives. It cleans the environment through carbon-neutral SCM in society.

An experimental game to assess hunter's participation in zoonotic diseases surveillance.

BACKGROUND: Strengthening the surveillance of zoonotic diseases emergence in the wild meat value chains is a critical component of the prevention of future health crises. Community hunters could act as first-line observers in zoonotic pathogens surveillance systems in wildlife, by reporting early signs of the possible presence of a disease in the game animals they observe and manipulate on a regular basis. METHODS: An experimental game was developed and implemented in a forested area of Gabon, in central Africa. Our objective was to improve our understanding of community hunters' decision-making when finding signs of zoonotic diseases in game animals: would they report or dissimulate these findings to a health agency? 88 hunters, divided into 9 groups of 5 to 13 participants, participated in the game, which was run over 21 rounds. In each round the players participated in a simulated hunting trip during which they had a chance of capturing a wild animal displaying clinical signs of a zoonotic disease. When signs were visible, players had to decide whether to sell/consume the animal or to report it. The last option implied a lowered revenue from the hunt but an increased probability of early detection of zoonotic diseases with benefits for the entire group of hunters. RESULTS: The results showed that false alerts-i.e. a suspect case not caused by a zoonotic disease-led to a decrease in the number of reports in the next round (Odds Ratio [OR]: 0.46, 95% Confidence Interval [CI]: 0.36-0.8, p < 0.01). Hunters who had an agricultural activity in addition to hunting reported suspect cases more often than others (OR: 2.05, 95% CI: 1.09-3.88, p < 0.03). The number of suspect case reports increased with the rank of the game round (Incremental OR: 1.11, CI: 1.06-1.17, p < 0.01) suggesting an increase in participants' inclination to report throughout the game. CONCLUSION: Using experimental games presents an added value for improving the understanding of people's decisions to participate in health surveillance systems.

Leagility in the healthcare research: a systematic review.

BACKGROUND: Expenditure of healthcare services has been growing over the past decades. Lean and agile are two popular paradigms that could potentially contain cost and improve proficiency of the healthcare system. However no systematic review was found on leagilty in the healthcare research. This study aims at synthesizing the extant literature of leagility in the healthcare area to consolidate its potential and identify research gaps for future study in the field. METHODS: A systematic literature review is conducted following the PRISMA checklist approach. Studies were searched in multiple databases. The selection of articles was executed by dual-scanning of two researchers to ensure quality of data and relevance to the topic. Scientific articles published between January 1999 and November 2023 concerning leagile healthcare are analysed using Microsoft Excel and VOSviewer (version 1.6.18). RESULTS: Out of 270 articles identified from the inclusion and exclusion criteria, 24 were included in the review. A total of 11 target areas were identified in leagility applications in healthcare. Success and limiting factors of leagile healthcare were classified into macro and micro aspects and further categorized into six dimensions: policy, organization, human resources, marketing, operation management and technology. Moreover, four research gaps were revealed and suggestions were provided for future study. CONCLUSION: Leagility in the healthcare context is still being in its infancy. Few empirical validation was found in leagile healthcare literature. Further exploration into the application of theory in various sectors under the scope of healthcare is appealed for. Standardization and modularization, leadership support, skillfulness of professionals and staff training are the factors most frequently mentioned for a successful implementation of leagility in the healthcare sector.

Reasons for implementation success despite health system constraints: qualitative insights on 'what worked' for cotrimoxazole preventive therapy.

BACKGROUND: Although Cotrimoxazole preventive therapy (CPT) has shown to be highly efficacious in reducing morbidity and mortality among people living with Human immunodeficiency virus (HIV) under 'ideal world' study conditions, operational challenges are limiting its effectiveness when implementing in countries most affected by the HIV epidemic. The fact that Mozambican authorities reported high coverage of CPT among patients with HIV, has led to this qualitative case study aimed at exploring possible factors responsible for the successful implementation of CPT in the Province of Maputo. METHODS: Between February and April 2019, we individually interviewed nine governmental stakeholders, including the person responsible for the HIV Program, the person responsible for the TB Program and the person responsible for Pharmaceutical management at three administrative levels (central, provincial and district level). Interviews were recorded, transcribed, and analysed thematically using MAXQDA Analytics Pro. Findings were translated from Portuguese into English. RESULTS: Five themes iteratively emerged: (a) Role of governance & leadership, (b) Pharmaceutical strategies, (c) Service delivery modifications, (d) Health care provider factors, and (e) Patients' perspectives. Interviews revealed that continuous supply of cotrimoxazole (CTZ) had been facilitated through multiple-source procurement and a push-pull strategy. One part of CTZ arrived in kits that were imported from overseas and distributed to public health facilities based on their number of outpatient consultations (push strategy). Another part of CTZ was locally produced and distributed as per health facility demand (pull strategy). Strong district level accountability also contributed to the public availability of CTZ. Interviewees praised models of differentiated care, the integrated HIV service delivery and drug delivery strategies for reducing long queues at the health facility, better accommodating patients' needs and reducing their financial and organisational burden. CONCLUSIONS: This study presents aspects that governmental experts believed to be key for the implementation of CPT in the Province of Maputo, Mozambique. Enhancing the implementation outcomes - drug availability and feasibility of the health facility-based service delivery - seemed crucial for the implementation progress. Reasons for the remarkable patient acceptability of CPT in our study setting should be further investigated.

Health system lessons from the global fund-supported procurement and supply chain investments in Zimbabwe: a mixed methods study.

BACKGROUND: The Global Fund partnered with the Zimbabwean government to provide end-to-end support to strengthen the procurement and supply chain within the health system. This was accomplished through a series of strategic investments that included infrastructure and fleet improvement, training of personnel, modern equipment acquisition and warehouse optimisation. This assessment sought to determine the effects of the project on the health system. METHODS: This study employed a mixed methods design combining quantitative and qualitative research methods. The quantitative part entailed a descriptive analysis of procurement and supply chain data from the Zimbabwe healthcare system covering 2018 - 2021. The qualitative part comprised key informant interviews using a structured interview guide. Informants included health system stakeholders privy to the Global Fund-supported initiatives in Zimbabwe. The data collected through the interviews were transcribed in full and subjected to thematic content analysis. RESULTS: Approximately 90% of public health facilities were covered by the procurement and distribution system. Timeliness of order fulfillment (within 90 days) at the facility level improved from an average of 42% to over 90% within the 4-year implementation period. Stockout rates for HIV drugs and test kits declined by 14% and 49% respectively. Population coverage for HIV treatment for both adults and children remained consistently high despite the increasing prevalence of people living with HIV. The value of expired commodities was reduced by 93% over the 4-year period. Majority of the system stakeholders interviewed agreed that support from Global Fund was instrumental in improving the country's procurement and supply chain capacity. Key areas include improved infrastructure and equipment, data and information systems, health workforce and financing. Many of the participants also cited the Global Fund-supported warehouse optimization as critical to improving inventory management practices. CONCLUSION: It is imperative for governments and donors keen to strengthen health systems to pay close attention to the procurement and distribution of medicines and health commodities. There is need to collaborate through joint planning and implementation to optimize the available resources. Organizational autonomy and sharing of best practices in management while strengthening accountability systems are fundamentally important in the efforts to build institutional capacity.

Waste not, want not: Value chain stakeholder attitudes to surplus dairy calf management in Australia.

The management of surplus dairy calves in Australia has traditionally been influenced by the economic viability of different practices. When beef prices are favourable, more surplus calves are raised for beef, and when beef prices are low, more calves are killed in the first few days of life. Early life killing of surplus calves may however threaten the dairy industry's social licence to operate. The aim of this study was to describe the views of value chain stakeholders regarding the management of surplus calves. Representatives from seven post-farm gate organisations participated in semi-structured interviews and were asked about their views on current practices, alternatives to early life killing and how best to implement change. Responses were analysed using inductive thematic analysis and were organised into three themes: (1) ethics of surplus calf management; (2) economics of surplus calf management; and (3) moving towards solutions including approaches to affecting change. We conclude that stakeholders widely recognised early life killing of surplus calves as a threat to the industry's social licence. Whilst technical solutions such as beef on dairy breeding programmes were cited as important, participants emphasised that implementing sustainable solutions will require collaboration, leadership, and commitment by all stakeholders along the value chain.

Prevalence of Listeria monocytogenes in Milk and Dairy Product Supply Chains: A Global Systematic Review and Meta-analysis.

Listeria monocytogenes, one of the main foodborne pathogens, is commonly found in milk and dairy products. This study aimed to estimate the presence of L. monocytogenes in milk and dairy product supply chains using a meta-analysis based on PubMed, Embase, Web of Science, and Scopus databases. A total of 173 studies were included in this meta-analysis. The pooled prevalence in the supply chain environment was 8.69% (95% confidence interval [CI]: 5.30%-12.78%), which was higher than that in dairy products (4.60%, 95% CI: 1.72%-8.60%) and milk products (2.93%, 95% CI: 2.14%-3.82%). Subgroup analysis showed that L. monocytogenes prevalence in raw milk (3.44%, 95% CI: 2.61%-4.28%) was significantly higher than in pasteurized milk (0.60%, 95% CI: 0.00%-2.06%). The highest prevalence of L. monocytogenes in milk and dairy products was observed in North America (5.27%, 95% CI: 2.19%-8.35%) and South America (13.54%, 95% CI: 3.71%-23.37%). In addition, studies using culture and molecular methods (5.17%, 95% CI: 2.29%-8.06%) had higher prevalence than other detection methods. Serogroup 1/2a and 3a (45.34%, 95% CI: 28.74%-62.37%), serogroup 1/2b and 3b (14.23%, 95% CI: 6.05%-24.24%), and serogroup 4b/4e (13.71%, 95% CI: 6.18%-22.83%) were dominant in these studies. The results of this study provide a better understanding of the prevalence of L. monocytogenes in milk and dairy product supply chains and suggest a potential foodborne pathogen burden.

Does reusable mean green? Comparison of the environmental impact of reusable operating room bed covers and lift sheets versus single-use.

INTRODUCTION: As hospitals strive to reduce their environmental footprint, there is an ongoing debate over the environmental implications of reusable versus disposable linens in operating rooms (ORs). This research aimed to compare the environmental impact of reusable versus single-use OR bed covers and lift sheets using life cycle assessment (LCA) methodology. METHODS: LCA is an established tool with rigorous methodology that uses science-based processes to measure environmental impact. This study compared the impacts of three independent system scenarios at a single large academic hospital: reusable bed covers with 50 laundry cycles and subsequent landfill disposal (System 1), single-use bed covers with waste landfill disposal (System 2), and single-use bed covers with waste disposal using incineration (System 3). RESULTS: The total carbon footprint of System 1 for 50 uses was 19.83 â€‹kg carbon dioxide equivalents (CO2-eq). System 2 generated 64.99 â€‹kg CO2-eq. For System 3, the total carbon footprint was 108.98 â€‹kg CO2-eq. The raw material extraction for all the material to produce an equivalent 50 single-use OR bed cover kits was tenfold more carbon-intensive than the reusable bed cover. Laundering one reusable OR bed cover 50 times was more carbon intensive (12.12 â€‹kg CO2-eq) than landfill disposal of 50 single-use OR bed covers (2.52 â€‹kg CO2-eq). DISCUSSION: Our analysis demonstrates that one reusable fabric-based OR bed cover laundered 50 times, despite the carbon and water-intensive laundering process, exhibits a markedly lower carbon footprint than its single-use counterparts. The net difference is 45.16 â€‹kg CO2-eq, equivalent to driving 115 miles in an average gasoline-powered passenger vehicle. This stark contrast underscores the efficacy of adopting reusable solutions to mitigate environmental impact within healthcare facilities.