Oxygen flow: How much do we know?

Introduction: Since the advent of Covid, oxygen has been the centre of discussion despite being the most important entity for the survival of human life. As various modes of its delivery has been in practice for a long time, using the non-rebreather mask has been a part of most guidelines for emergencies and hypoxia. This requires a higher flowrate of up to 15 l/min. Most flowmeters can deliver upto 75 l/min over the maximum calibrated mark.1 What may appear as a small rise from the maximum labelled mark can deliver more oxygen than required and result in wastage of oxygen or hide the severity of the patient's condition. Using this audit/ QIP we are trying to determine if the flowrates delivered are as per the prescription/protocol. Aim(s): To find out if the oxygen administration when it is prescribed at 15L/min is at the prescribed value and therefore quantify the amount of oxygen that is being wasted. Method(s): Data was collected randomly, observing the flow rates that the patients were receiving as prescribed or over the prescribed rate for those on non rebreather mask. Result(s): 54 observations were recorded from ED, ITU, AMU and theatre recovery across two hospitals. It was found that 57.4% of the patients were on flowrates more than the prescribed value. Conclusion & Discussion: More than half the patients requiring high flow rate of oxygen were on rates more than prescribed. This is potentially due to the lack of understanding of the calibration of the flowmeter. This results in the wastage of oxygen causing significant financial loss and an increase in the carbon dioxide emission impacting the environmental pollution. We plan to run an educational intervention for staff in these departments to emphasise the importance of administering drugs (including oxygen) as they are prescribed, and how easy it is to over administer oxygen.

Microalgal Carbon Dioxide (CO2) Capture and Utilization from the European Union Perspective

The increasing concentration of anthropogenic CO2 in the atmosphere is causing a global environmental crisis, forcing significant reductions in emissions. Among the existing CO2 capture technologies, microalgae-guided sequestration is seen as one of the more promising and sustainable solutions. The present review article compares CO2 emissions in the EU with other global economies, and outlines EU's climate policy together with current and proposed EU climate regulations. Furthermore, it summarizes the current state of knowledge on controlled microalgal cultures, indicates the importance of CO2 phycoremediation methods, and assesses the importance of microalgae-based systems for long-term storage and utilization of CO2. It also outlines how far microalgae technologies within the EU have developed on the quantitative and technological levels, together with prospects for future development. The literature overview has shown that large-scale take-up of technological solutions for the production and use of microalgal biomass is hampered by economic, technological, and legal barriers. Unsuitable climate conditions are an additional impediment, forcing operators to implement technologies that maintain appropriate temperature and lighting conditions in photobioreactors, considerably driving up the associated investment and operational costs.

Forecasting carbon dioxide emission price using a novel mode decomposition machine learning hybrid model of CEEMDAN-LSTM

Global carbon dioxide emissions have become a great threat to economic sustainability and human health. The carbon market is recognized as the most promising mean to curb carbon emissions, furthermore, carbon price forecasting will promote the role of the carbon market in emissions reduction and achieve reduction targets at lower economic costs for emission entities. However, there are still some technical problems in carbon price prediction, such as mode mixing and larger reconstruction error for the traditional empirical mode decomposition-type models. Therefore, the innovation of this paper is constructing a novel carbon price prediction model of complete ensemble empirical mode decomposition with adaptive noise (CEEMDAN)-long short-term memory (LSTM), that combines the advantages of CEEMDAN in decomposing the multiscale time-frequency carbon price signals and the LSTM model in fitting the financial signals. The results show the proposed CEEMDAN-LSTM model has significant accuracy in predicting the complex carbon price signals. The prediction error and expectation indicators of root mean square error, mean absolute error, mean absolute percentage error, and direction accuracy are 0.638342, 0.448695, 0.015666, and 0.687631, respectively, which is better than other benchmark models. Further evidence convince that the short-term forecasting performance is superior to the long-term and medium-term performance. That evidence concludes that the proposed model is a reliable method to reveal the carbon price-driving mechanism from the point of multiscale time-frequency characteristics. Particularly, short-term forecasting is more accurate and can provide a valuable technical reference for reduction entities and green financial companies to judge the market situation and formulate quantitative transactions.

Potential impacts of COVID-19 pandemic on Turkish economy and its carbon dioxide emissions: an extended input-output analysis

COVID-19 pandemic has lead to societal transformation in terms of economic, social, and environmental behaviours. Like other countries, Turkey has suffered from the pandemic. The aim of this study was to investigate the impacts of COVID-19 on the following major indicators: total hours worked by employees, number of employees, labour compensation, capital compensation, gross value added and nominal capital stock at current basic prices, and carbon dioxide (CO2) emissions. Throughout the study, an extended input-output (EIO) analysis was employed. The scope of the study was based on the decline in economic activities in the restricted sectors such as accommodation and food services, travel agencies, tour operators and other reservation and related services, air transport, land tourism, water transport, and leisure activities. Three main scenarios, i.e., fast recovery scenario, continuing slowdown scenario, and economic recession scenario, were set to analyse the effects of COVID-19 on the Turkish economy and CO2 emissions.

Multi-Modal Evaluation of the East Midlands Gi Webinar Series: A Trainee-Led Innovation Born out of Adversity

Introduction: The COVID-19 pandemic led to the suspension of all faceto- face teaching for gastroenterology trainees in the UK. From June 2020, we organised and delivered a weekly webinar, mapped to the UK higher speciality training (HST) gastroenterology curriculum, comprising a 40-minute lecture, delivered by an international multi-disciplinary faculty, followed by 10-20 minutes of moderated discussion via Microsoft Teams. Webinars were coordinated and moderated live by East Midlands Gastroenterology trainees and made available on demand for attendees to view in between commitments. Any professional in Gastroenterology, including trainees, consultants and allied health professionals, not limited to geographical location, was allowed to request access to the platform. Aims & Methods: We aimed to perform a multi-modal evaluation of the webinar series. First, we reviewed participants' demographics and weekly webinar attendance data. Second, we conducted a curriculum-mapping exercise of the programme to identify the breadth of topics covered. Third, we conducted two web-based feedback surveys in June 2021 and April 2022 to assess participants' satisfaction with the webinar series. Finally, since the webinar series has substituted face-to-face training for East Midlands trainees, we performed a projected calculation of CO2 emission saving based on the cessation of face-to-face teaching within the East Midlands region. Result(s): Between June 2020 and April 2022, a total of 84 webinars were delivered by 68 consultants, 13 senior trainees and two allied health care professionals. 47.6% of the speakers were from outside East Midlands. A total of 746 participants were registered on the online platform, of whom 85.6% were from the UK and 14.4% were from abroad. Live attendance data were available for 33 sessions (mean 55 +/- 13 attendees). The webinar series has, so far, covered over 80% of the UK HST gastroenterology curriculum. Fifty-nine participants and 20 participants completed the first and second feedback surveys, respectively. 98% of the first survey respondents felt that the webinars fulfilled their educational goals and 100% rated the programme's quality as good/very good. This positive feedback was sustained during the second survey with 100% reporting that the webinars fulfilled their educational goals and 90% rating the programme's quality as good/very good. 97% of the first survey respondents and 100% of the second survey respondents wanted the webinar series to continue, even when face-to-face teaching resumes. Using the East Midlands region as an example, we estimate a saving of >2.9 metric tons in CO2 emission/region, equivalent to the recycling of one ton of waste/year from the replacement of face-to-face with web-based teaching. Conclusion(s): We have demonstrated that the East Midlands Gastroenterology webinar series is a greener, highly valued, and sustainable trainee-led innovation, bringing together an international community of gastroenterology practitioners. A significant proportion of the UK HST curriculum can be delivered online. Future evaluations should aim to evaluate the scalability of such innovation across different programmes in different settings.

Impact of Telemedicine on Financial Burden to Patients and Carbon Footprint at an Endocrine Oncology Clinic

Introduction: Since the onset of the COVID-19 pandemic, telemedicine has become an increasingly utilized resource in all fields of medicine, allowing greater access to and efficiency of medical care. This study seeks to quantify the average reduction in cost to patients and carbon footprint attributable to telemedicine for endocrine cancer care. Method(s): This retrospective cohort study includes telemedicine visits for in-state patients from April 1, 2020, to June 20, 2021, at the endocrine oncology clinic of a single National Cancer Institute-designated comprehensive cancer center. The primary outcome is cost savings of endocrine cancer care with use of telemedicine. This includes 2 components: (1) direct costs of travel (round-trip distance of car travel) and (2) loss of productivity due to the clinic visit (loss of income from travel and in-office visit time). The secondary outcome is reduction of carbon footprint (kg CO2 emissions) with use of telemedicine. Result(s): There were 3171 telemedicine visits for 2921 patients conducted within the designated time frame. Telemedicine was associated with total savings of 494,895 round-trip travel miles for patients (9734 hours total drive time). An additional 3613 hours were saved in accounting for time to park, enter the building, and wait. Telemedicine resulted in an average savings of $145/visit for patients under 65 years old and $111/visit for patients greater than 65 years old. Additionally, telemedicine reduced the carbon footprint by an average of 46.18 kg CO2 emissions per visit. Conclusion(s): As the costs of medical care continue to rise, further implementation of telemedicine may result in significant savings for patients. This study found that telemedicine is associated with reduction in financial burden caused by both travel and time costs. Additionally, implementation of telemedicine may significantly reduce the carbon footprint of endocrine cancer care. These data need to be interpreted in the context of clinical efficacy of the telemedicine visit, which will require additional study of clinical impact, patient satisfaction, and oncological outcomes.

The Reduced Environmental Impact of American Radium Society's 2021 Virtual Annual Meeting

Background: In response to the threat of the COVID-19 pandemic, the 2021 American Radium Society (ARS) Annual Meeting transitioned to a virtual, online conference. As medical conferences around the world have transitioned to virtual formats, numerous benefits have been uncovered;however, the environmental effect of reduced travel on carbon emissions remains largely unknown. Today, it is estimated that conference attendance accounts for 35% of a scientist's total carbon footprint [1]. Given that the climate crisis is a growing threat to human health and oncology outcomes [2], it is imperative to begin to quantify, understand, and promote sustainable practices. Objective(s): We aim to highlight the reduced travel-related greenhouse emissions associated with the transition of ARS's 2021 Annual Meeting to a virtual platform in comparison to the 2019 in-person conference in Monarch Beach, California. Method(s): Data from the attendees of the ARS Annual Meeting was collected from 2019 and 2021 (the conference was cancelled in 2020). The distance traveled per attendee to the 2019 location (Dana Point, CA) and the 2021 intended conference location (Lahaina, HI) was estimated using the location of the attendees' home institutions. The mode of transportation was hypothesized based on distance traveled (automobiles < 300 miles;airline >= 300 miles). Approximate carbon dioxide (CO2) emissions were calculated using the Environmental Protection Agency's Greenhouse Gas Tools [3,4]. For the 2021 virtual conference, it was assumed that no travel took place. Alternatively, the associated CO2 emissions were estimated based on assumed internet usage (8 hours/day for the 3-day conference period) and food delivery (5 miles) for one meal which was sent free to each attendee. Additionally, the distance that would have been traveled by attendees to Hawaii was estimated. Result(s): A total of 591 conference attendees were identified, 253 in 2019 and 338 in 2021. For the 2019 in-person conference, the total carbon footprint for all assumed methods of transportation was determined to be 187,935.9 lbs of CO2 emissions, with an average of 820.7 lbs of CO2 emissions per attendee. Total emissions were equivalent to the emissions of 18.5 passenger vehicles for one year. Alternatively, the CO2 emissions spared during the 2021 virtual conference was estimated to be 519,153.5 lbs, the equivalent of 51 passenger vehicles for one year. However, emissions related to teleconference internet streaming and food delivery accounted for a total of 2,693.0 and 1535.8 lbs of CO2. Conclusion(s): Incorporating options for virtual attendance at academic conferences has the potential to significantly reduce carbon emissions. However, many believe that virtual networking cannot replace in-person interactions particularly for early-career attendees. Regardless, our professional societies have an obligation to investigate and promote greater sustainability of our annual meetings.

The reduced environmental impact of American society of Clinical Oncology's 2021 virtual annual meeting

Background: In response to the threat of the COVID-19 pandemic, the 2021 American Society of Clinical Oncology (ASCO) Annual Meeting transitioned to a virtual, online conference. As medical conferences around the world have transitioned to virtual formats, numerous benefits have been uncovered;however, the environmental effect of reduced travel on carbon emissions remains largely unknown. Today, it is estimated that conference attendance accounts for 35% of a scientist's total carbon footprint. Given that the climate crisis is a growing threat to human health and oncology outcomes, it is imperative to begin to quantify, understand, and promote sustainable practices. We aim to highlight the reduced travel-related greenhouse emissions associated with the transition of ASCO's 2021 Annual Meeting to a virtual platform in comparison to a hypothetical in-person conference. Methods: Attendee demographic data was collected online from the ASCO 2021 Annual Meeting. The distance traveled per attendee to a hypothetical in-person conference in Chicago, Illinois (the location for the 2022 Annual Meeting) was estimated using reported attendees' home country and a hypothesized centralized location. Approximate airline miles and associated carbon dioxide (CO2) emissions were calculated using the Environmental Protection Agency's Greenhouse Gas Tools. It was assumed that all attendees had non-stop airfare and traveled in economy class. The approximate CO2 emissions for the virtual conference was estimated based on assumed internet usage (8 hours/day for the 5-day conference period). Results: A total of 32,950 conference attendees were identified - 14,150 domestic attendees and 16,050 international attendees. For the hypothesized in-person conference, the total carbon footprint for all assumed transportation was determined to be 28,468,031.25 lbs. of CO2 emissions, with an average of 863.0 lbs. of CO2 emissions per attendee. Alternatively, emissions related to virtual conference internet streaming accounted for a total of 436,258 lbs of CO2. Total emissions spared with the transition to a virtual platform was an estimated 28,031,773.25 lbs of CO2., the equivalent emissions of 1,531 U.S. homes' energy use for one year. Conclusions: Incorporating options for virtual attendance at academic conferences has the potential to significantly reduce carbon emissions. However, many believe that virtual networking cannot replace in-person interactions particularly for early-career attendees. Regardless, our professional societies have an obligation to investigate and promote greater sustainability of our annual meetings.

Robots in healthcare: now and in the future

Purpose Robotic systems are increasingly applied in healthcare (HC) but are confined to heavy load tasks (e.g. within a hybrid OR), are used for undemanding services (e.g. transport and supply) or as master-slave systems aim at increasing the precision of interventional procedures. Only minor they have become substitutes of medical personnel, only minor they have improved the quality of health care delivery and only minor they have truly been integrated in our clinics. The future health system is facing some critical problems, with the shortage of personnel and the maintenance of the quality of care being first in line. Robots offer quite attractive features to cover with these problems but need to be designed accordingly, have to provide autonomous tasks and have to become full team members. The article aims at the identification of weak points of the health care system and how robots can be used to shape its future. Methods The results and thoughts presented herein do originate from expert discussions and studies of the available literature, but do also originate from experiences made in course in daily practice. Also, aspects which were elaborated during the work on the patient hub concept [1] and have been debated in panel discussion on the OR of the future and on robots in healthcare are included. Still, the presented theses are speculative and visionary and thus cannot be based on a fully scientific background. Results Personnel shortage The most pressing challenge we are facing for the healthcare system is the shortage of personal, which became even more obvious during the COVID-19 pandemia. As it foreseeable, that we will not be able to replace missing workers by human personnel, care delivery must become les human depending and missing work craft has to be replaced by autonomous systems. Autonomous robotic systems represent a core technology in this respect and can help to take over simple and repetitive tasks, e.g. for the handling of medical goods, for bedding and mobilizing patients and rehabilitation. Climate change The HC system will also be affected by the warming of the atmosphere, as it is responsible for almost 5% of CO2 emissions. Transport and delivery of medical goods in this regard are the main contributors and could be optimized by reducing the rate of single-use devices and scaling down supply chains. Increasing the in-hospital sterilization capacities and implementing local fabrication facilities of medical devices might offer a solution here, however, would require human resources. Robots again can play a decisive role here and become an enabling technology, e.g. during the reprocessing of sterile goods and for 3D printing based manufacturing lines. Demographic change The aging of the population is becoming a relevant burden for society due to the increasing number of disabled people and people in need of care. Since families and the HC system cannot cope with this development, solutions must be found that support the independence and self-subsistence of the elderly. Care robots, mechatronic extraskeletons and smart assistive technologies for the home are key elements for caring for elderly people in a way that is gentle on staff and can also help to maintain their quality of life. Specialization and precision medicine The healthcare system is driven by striving for improved quality of service and precision medicine. Currently available systems, mainly master-slave devices have failed in contributing here as no superiority has been shown for robotic assisted surgeries so far. Nevertheless, robots are the most powerful solution for further reducing the access trauma, for miniaturizing devices and for the realization for autonomous capabilities by coupling with smart imaging solutions. As it was demonstrated with OCT-based microrobotic solutions for eye surgery, comparable solutions might be a driving technology for example for endovascular surgeries, brain surgery and endoscopic interventions. While surgeons become more and more specialized which maks their individual performance of high va ue assistive systems to take over less-demanding tasks (e.g. skin suturing, retraction, suction) could become a meaningful and resource-sparing aid and once again could be realized by robotic solutions. Multi-drug resistance and isolation As observed by patients suffering from multi-drug resistance even before the current pandemia an increasing number of patients are requiring isolated care. The isolated care is not only demanding in terms of personnel, but also produces enormous amounts of waste, which have a negative effect on CO2 emissions. Robots again offer here a valuable solution as they can remain in an isolated environment, as they can be disinfected which makes additional protective measures unnecessary and as they strictly follow to standard operative procedures thereby reducing the risk of unintended contamination. Conclusion Solutions to overcome the pending, or already present challenges in the HC system are urgently required and must provide autonomic functionalities to save personnel, have to reduce the amount of waste and HC related traffic to lower the Co2 emission and should enable us to develop smarter and less invasive approaches for the treatment of an increasing number of sick and care-depending patients. Numerous robotic solutions to cope with this problems have already been introduced [2], but need to be further adapted according to these requirements and fully integrated into a cooperative environment. The alignment between human and robotic tasks and the maintenance of ethical and legal aspects still have to be taken as unsolved problems for the further involvement of robots, however when solved could open up the basis for a highly efficient patient centred HC system.

High Patient Satisfaction and Acceptability of Tele-Neurology Consultations at a Regional Tertiary Referral Hospital in Kenya During the COVID-19 Pandemic

Objective: To demonstrate the effectiveness and usability of a novel tele-neurology service in Nairobi. Background: There is severe shortage of neurology healthcare workers in low-/lower-middle income countries (LLMICs), especially in Africa. Tele-neurology consultations (TNC), necessitated widely due to the COVID-19 pandemic, have been demonstrated to be effective in bridging neurology service gaps, but there is little evidence of TNC effectiveness in LLMICs. Design/Methods: We conducted a prospective cross-sectional study, enrolling neurology patients referred to our tertiary referral neurology outpatients center over 12 months from October 2020. We measured satisfaction and acceptability using Likert scales, and compared TNC to face-to-face (F2F) consultations. TNC were delivered as per 2020 British and American guidelines. Descriptive data are presented as median (inter-quartile range) and statistical comparisons made using paired student t-test. Results: From 219 enrolled patients, 66.7% (146/219) responded [74% (108/146) had both F2F and TNC]: age 40.9 (30.6-55.2) years;63.0% (92/146) female;2.7% (4/146) from neighboring countries;follow-up period with neurologist (DSS) 6.8 (1.5-29.8) months;and most common presentations were headache [30.8% (45/146)], seizure [26.0% (38/146)] and neurodegenerative [15.1% (22/146)] disorders. For TNC, >90%: (i) found it just as comfortable as F2F (p=0.35) and not in violation of their privacy;(ii) saved time [3.0 (2.0-4.0) hours], travel [11.0 (7.2-21.1) km] and cost [$10 (5-20)];(iii) felt satisfied with the care and that their neurological concerns were adequately addressed;and (iv) would use TNC again. Conversely, 15.1% (22/146) did not agree with TNC being as effective as F2F, including the neurologist identifying all their health problems satisfactorily (p=0.03). In total, our TNC service saved our patients $6,125, 1,143 hours, and 25,506km of travel, equating to 3.5 tons (21 trees) of carbon dioxide emissions. Conclusions: Our study demonstrates that our regionally unique TNC service is an acceptable, efficient, effective, and environmentally-friendly care delivery model in our resource-poor setting.

Index telephone two-week wait lower gastrointestinal clinics as a substitute to face to face outpatient appointments during the COVID-19 pandemic

Purpose/Background: The COVID-19 pandemic led to hospitals in the United Kingdom substituting face-to- face (FtF) clinics with virtual clinic (VC) appointments. We evaluated the impact of virtual two-week wait (2-ww) lower gastrointestinal (LGI) consultations on stakeholders at a district general hospital in England. Methods/Interventions: Patients undergoing index outpatient 2-ww LGI clinic assessment between 01/06/2019-31/ 10/2019 (FtF group) and 01/06/2020-31/ 10/2020 (VC group) were identified. Relevant data were obtained using electronic patient records. Compliance with national cancer waiting time targets (WTT) was assessed. Environmental and financial impact analyses were performed. Results/Outcomes: In total, 1531 patients were analysed (median age = 70, male = 852, 55.6%). Of these, 757 (49.4%) were assessed virtually via telephone;the remainder were seen FtF (n = 774, 50.6%). Ninety two (6%, VC = 44, FtF = 48) patients had malignant pathology and 64 (4.2%) had colorectal cancer (CRC);of these, 46 (71.9%, VC = 26, FtF = 20) underwent treatment with curative intent. The median waiting times to index appointment, investigation and diagnosis were significantly lower following VC assessment (p < 0.001). The cancer detection rates (p = 0.749), treatments received (p = 0.785) and median time to index treatment for CRC patients (p = 0.156) were similar. A significantly higher proportion of patients were seen within two weeks of referral in the VC group (p < 0.001). VC appointments saved patients a total of 9288 miles, 0.7 metric tonnes of CO2 emissions and £7482.97. Taxpayers saved £80,242.00 from VCs. No adverse events or complaints were reported in the VC group. Conclusion/Discussion: Virtual 2-ww LGI clinics were effective, safe and were associated with tangible environmental and financial benefits for stakeholders. (Figure Presented).

POS-319 TELENEPHROLOGY AS A PUBLIC POLICY FOR THE CARE OF PATIENTS WITH CKD AT THE PRIMARY HEALTH LEVEL. CHILEAN EXPERIENCE

Introduction: There are successful reports of the use of telemedicine in nephrology (TN), which would facilitate the access of patients with chronic kidney diseases (CKD) from the primary health centers (PHCs) to the nephrologist. Since 2019, TN has been implemented in Chile as a public health policy with national coverage. The process and outcome indicators associated with the Chilean National TN Program among PHCs and reference nephrologists are described. Methods: Descriptive study of asynchronous telemedicine care performed from urban and rural PHCs (574) (municipal health centers) to 17 nephrologists from Hospital Digital, between January 01, 2019 and June 30, 2021. The percentage of the rural population in Chile is 12.1%. Teleconsultations are sent by the PHCs doctor through a digital platform that contains clinical information, laboratory tests and treatments. The nephrologist in a deferred time, responds in the same way and decides between the options: 1) Counter-refer the patient to PHCs requesting more information or with treatment recommendations;2) Refer to a hospital for more complex studies or treatments. The following were analyzed: 1. Distribution by age, sex and comorbidities;2. Response times;3. Prevalence of CKD by stages;4. Destination post evaluation TN;5. Level of relevance of PHCs consultations. Results: In total, 12.705 asynchronous telemedicine visits were performed (2019: 50.8 %;2020: 31.9 %;2021:17.3%. During the Covid-19 pandemic, attention for TN was maintained although restricted by the health crisis in the public health network. The mean age was 65.9 (SD: 13.2) years;80% were older than 60 years;57%% women. CKD stages: S1 (8.5%%);S2 (16.2%);S3 (53.6%);S4 (17.9%) and S5 (3.7%). Comorbidities: diabetes 56%, hypertension 90.7%, dyslipidemia 65%, overweight 29.2% and obesity 38.7%. The average response time was 91 hrs. (range 1- 173). In total, 7.954 patients (62.6%) were referred to PHCs with recommendations, without requiring transfers to another center. In turn, 4.751 patients (37.4%) required face-to-face nephrological evaluation (58.1% high priority for CKD in stages 4-5). The relevance of the consultations according to the nephrologist's evaluation was considered high 23.1% and median 49.3%. Conclusions: The implementation of TN as a public policy has made it possible to facilitate expeditious access, evaluation and timely treatment of patients with CKD from urban and rural PHCs and prioritize face-to-face care by a nephrologist for those with greater risk or severity. Most of the patients evaluated (62.8%) were referred to PHCs, optimizing the limited space and high demand of face-to-face care per specialist. During the Covid-19 pandemic period, the use of TN was restricted but allowed continuity of control of patients with CKD and decongest PHCs and emergency care centers. Future studies should evaluate the impact of TN in the follow-up of patients screened with CKD, especially in stages 3-5, the decrease in travel-related CO2 emissions due to reduced displacement, the level of patient´s satisfaction/PHCs teams, and the evaluation effective cost of this care modality. No conflict of interest

Health Emergency Management in Public Administration: A Reproducible Model to Ensure Environmental Sustainability and Quality of the Spaces for Workers

Introduction: During the Covid19 pandemic, standard criteria were defined for the construction of new spaces to be used as vaccination centers, in relation to the goals of the UN 2030 agenda on environmental sustainability and quality of the spaces, for health and for the responsible consumption of resources during the emergency. The aim of this case study is to achieve a reproducible model based on the criteria of economic sustainability of the public administration, potentially expandable in other sectors as cooperation and development. Materials and Methods: A Rapid Response Team, trained with the WHO guidelines, was established for the definition of the essential requirements of the new vaccination centers, following a specific checklist set up from a SWOT Analysis. The project was calibrated in all phases of the vaccination cycle process, through functional and metric relationships. The new centers have also been designed to ensure the social inclusion and privacy of users. Result: The centers were set up in about 20 days. The checklist and data collection have allowed to optimize the process and the efficiency of the linear conformation, guaranteeing an increase of 15% of space for each phase of the vaccination cycle according to the length of stay of workers. All phases were fully digitized with a 100% accuracy of data management. In 9 months, the savings of paper filing, compared to CO2 emissions, were 40.19Kt. Conclusions: Our model can be easily reproduced in other contexts, ensuring efficiency, exploiting new digital technologies and the quality of education.

Estimations of carbon footprint from electricity consumption during covid-19 lockdown and pre-lockdown in butuan city

The electricity consumption for commercial, residential, and industrial sectors is considered the primary cause of increasing carbon dioxide emissions. To calculate the carbon footprint, the researcher used Carbon Footprint Ltd. This study aims to quantify the carbon footprint associated with the consumption of electricity by sectors (residential, commercial, industrial, public buildings, and streetlights) in Butuan City during the pre-lockdown period (January and February), and then compare these with the carbon footprint calculated during the lockdown period (March and April 2020). A GIS-based approach was applied to generate the spatial distribution across the 86 barangays of Butuan City. The study findings that the carbon footprint in the lockdown period is ∼ −17% lower than the mean carbon footprint calculated for the pre-lockdown period. In absolute values, the total estimated carbon footprint during the pre-lockdown and lockdown period was ∼ 10,947 mtCo2e and ∼ 9,138 mtCo2e, respectively. Furthermore, the findings imply that the central and northern areas have the highest impact of savings on average ∼ 130 mtCo2e of greenhouse gas avoided by barangays. This research provides quantitative insight to understand the measured generated in lockdown and pre-lockdown periods. © International Archives of the Photogrammetry, Remote Sensing and Spatial Information Sciences - ISPRS Archives