Objectives: GI endoscopy units represent the third largest producers of medical waste. We aimed to determine endoscopic instrument composition and life cycle assessment (LCA) and to assess a sustainability proposal based on a mark on the instruments that identifies parts can be safely recycled or ‘ green mark ’. Design: Material composition analysis and LCA of forceps, snares and clips from four different manufacturers (A–D) were performed with four different methods. Carbon footprint from production, transportation and end of life of these instruments was calculated. In 30 consecutive procedures, we marked the contact point with the working channel. 5 cm away from that point was considered as green mark . One-week prospective study was conducted with 184 procedures evaluating 143 instruments (75 forceps, 49 snares and 19 haemoclips) to assess the efficacy of this recyclable mark. Results: Composition from different manufacturers varied widely. Most common materials were high global warming potential (GWP) waste (polyethylene, polypropylene and acrylonitrile) and low GWP waste (stainless steel). Significant differences were found for the forceps (0.31–0.47 kg of CO ₂ equivalent (CO ₂ -eq)) and haemoclips (0.41–0.57 kg CO ₂ -eq) between the manufacturers. Green mark was established 131.26 cm for gastroscope and 195.32 cm for colonoscope. One-week activity produced 67.74 kg CO ₂ -eq. Applying our sustainability intervention, we could reduce up to 27.44% (18.26 kg CO ₂ -eq). This allows the recycling of 61.7% of the instrument total weight (4.69 kg). Conclusion: Knowledge of carbon footprint is crucial to select the most sustainable alternatives because there are large variations between brands. A mark to identify recyclable parts could reduce our environmental impact significantly.

Muscle tissue possess an innate regenerative potential that involves an extremely complicated and synchronized process on which resident muscle stem cells play a major role: activate after an injury, differentiate and fuse originating new myofibers for muscle repair. Considerable efforts have been made to design new approaches based on material systems to potentiate muscle repair by engineering muscle extracellular matrix and/or including soluble factors/cells in the media, trying to recapitulate the key biophysical and biochemical cues present in the muscle niche. This work proposes a different and simple approach to potentiate muscle regeneration exploiting the interplay between specific cell membrane receptors. The simultaneous stimulation of borate transporter, NaBC1 (encoded by SLC4A11gene), and fibronectin-binding integrins induced higher number and size of focal adhesions, major cell spreading and actin stress fibers, strengthening myoblast attachment and providing an enhanced response in terms of myotube fusion and maturation. The stimulated NaBC1 generated an adhesion-driven state through a mechanism that involves simultaneous NaBC1/α5β1/αvβ3 co-localization. We engineered and characterized borax-loaded alginate hydrogels for an effective activation of NaBC1 in vivo. After inducing an acute injury with cardiotoxin in mice, active-NaBC1 accelerated the muscle regeneration process. Our results put forward a new biomaterial approach for muscle repair.

This study performed a multifactorial carbon footprint assessment and sensitivity analysis of colonoscopy. This was a 1-week, single-center, prospective study including all outpatient diagnostic colonoscopies (n = 66). A cradle-to-grave life-cycle assessment methodology evaluated all essential supplies (accessories #1–15), endoscopic procedure (energy consumption, carbon dioxide [CO2] insufflation, bowel preparation, sedation), staff and patient transport, and waste management. The impact assessment was based on sensitivity analysis in different scenarios (base, best, worst) to calculate the Global Warming Potential over 100 years (GWP-100 measured in kg of CO2 equivalent [kgCO2e]). GWP-100 of a single colonoscopy was estimated to be 18.09 kgCO2e in the base scenario, with patient (8.61 kgCO2e) and staff (5.09 kgCO2e) transport, colonoscope manufacture and reprocessing (2.1 kgCO2e), and supplies (1.91 kgCO2e) contributing 47.6%, 28.1%, 11.7%, and 10.6%, respectively. Nitrile gloves, underpads, and a disposable peripheral oxygen saturation sensor accounted for nearly 50% of the total carbon footprint of all supplies. Patient preparation (bowel preparation, sedation, and CO2 insufflation) and energy consumption contributed only 2.0%. Staff and patient travel showed significant variations among worst, base, and best scenarios, with 18.8, 13.7, and 10.2 kgCO2e, respectively. The use of different amounts of medical supplies raised the carbon footprint to 2.38 kgCO2e in the worst scenario or diminished it to 1.56 kgCO2e in the best case. This analysis and multifactorial colonoscopy procedure assessment confirmed patient and staff transport as the main carbon footprint contributors. More sustainable and smarter transport could considerably lower the environmental impact of colonoscopy.

Ironically, healthcare systems are key agents in respiratory-related diseases and estimated deaths because of the high impact of their greenhouse gas emissions, along with industry, transportation, and housing. Based on safety requirements, hospitals and related services use an extensive number of consumables, most of which end up incinerated at the end of their life cycle. A thorough assessment of the carbon footprint of such devices typically requires knowing precise information about the manufacturing process, which is rarely available in detail because of the many materials, pieces, and steps involved during the fabrication. Yet, the tools most often used for determining the environmental impact of consumer goods require a bunch of parameters, mainly based on the material composition of the device. Here, we report a basic set of analytical methods that provide the information required by the software OpenLCA to calculate the main outcome related to environmental impact, greenhouse gas emissions. Through thermogravimetry, calorimetry, infrared spectroscopy, and elemental analysis, we proved that obtaining relevant data for the calculator in the exemplifying case of endoscopy tooling or accessories is possible. This routine procedure opens the door to a broader, more accurate analysis of the environmental impact of everyday work at hospital services, offering potential alternatives to minimize it.

A novel procedure to obtain smooth, continuous polymeric surfaces from poly(glycerol sebacate) (PGS) has been developed with the spin-coating technique. This method proves useful for separating the effect of the chemistry and morphology of the networks (that can be obtained by varying the synthesis parameters) on cell-protein-substrate interactions from that of structural variables. Solutions of the PGS pre-polymer can be spin-coated, to then be cured. Curing under variable temperatures has been shown to lead to PGS networks with different chemical properties and topographies, conditioning their use as a biomaterial. Particularly, higher synthesis temperatures yield denser networks with fewer polar terminal groups available on the surface. Material-protein interactions were characterised by using extracellular matrix proteins such as fibronectin (Fn) and collagen type I (Col I), to unveil the biological interface profile of PGS substrates. To that end, atomic force microscopy (AFM) images and quantification of protein adsorbed in single, sequential and competitive protein incubations were used. Results reveal that Fn is adsorbed in the form of clusters, while Col I forms a characteristic fibrillar network. Fn has an inhibitory effect when incubated prior to Col I. Human umbilical endothelial cells (HUVECs) were also cultured on PGS surfaces to reveal the effect of synthesis temperature on cell behaviour. To this effect, early focal adhesions (FAs) were analysed using immunofluorescence techniques. In light of the results, 130 °C seems to be the optimal curing temperature since a preliminary treatment with Col I or a Fn:Col I solution facilitates the formation of early focal adhesions and growth of HUVECs.

Poly(glycerol sebacate) (PGS) belongs to the hyperbranched polyesters family (HBP), which possesses an extensive variety of applications due to its tunable chemical and mechanical properties, together with its biocompatibility and biodegradability. However, the understanding of PGS synthesis becomes a challenge due to the lack of consistency when determining its synthesis parameters. Understanding these parameters is fundamental to control PGS synthesis and obtain a scalable and reproducible final product for biomedical applications. To unveil their effect on diverging PGS properties, diols are used as glycerol analogs and the reaction is chemically and thermally monitored, suggesting a heterogeneous reactivity of the exposed hydroxyl groups. Also, confinement of the prepolymerization is proven to be fundamental In order to maintain the equimolar ratio of initial monomers during synthesis. Early stages of the polycondensation (first 4 h) tend to linear and less branched oligomers by consuming primary hydroxyls rather than secondary hydroxyls. However, physicochemical characterization determines that a high degree of conversion (40%) is reached during these early stages. Afterward, the oligomers tend to condense through the secondary hydroxyls into a more crosslinked elastomer. This study demonstrates how hydroxyl affinity, water presence, and glycerol loss are crucial for the scalability and reproducibility of its final product.