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A matter of new life and cell death: programmed cell death in the mammalian ovary

The mammalian ovary is a unique organ that displays a distinctive feature of cyclic changes throughout the entire reproductive period. The estrous/menstrual cycles are associated with drastic functional and mo...

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Engineered extracellular vesicles carrying let-7a-5p for alleviating inflammation in acute lung injury

Acute lung injury (ALI) is a life-threatening respiratory condition characterized by severe inflammation and lung tissue damage, frequently causing rapid respiratory failure and long-term complications. The mi...

The rise of big data: deep sequencing-driven computational methods are transforming the landscape of synthetic antibody design

Synthetic antibodies (Abs) represent a category of artificial proteins capable of closely emulating the functions of natural Abs. Their in vitro production eliminates the need for an immunological response, st...

Tick-borne encephalitis virus transmitted singly and in duo with Borrelia burgdorferi sensu lato and Anaplasma phagocytophilum bacteria by ticks as pathogens modifying lipid metabolism in human blood

Ticks are vectors of various pathogens, including tick-borne encephalitis virus causing TBE and bacteria such as Borrelia burgdorferi sensu lato and Anaplasma phagocytophilum causing e.g. viral-bacterial co-infec...

Integration of transcription regulation and functional genomic data reveals lncRNA SNHG6’s role in hematopoietic differentiation and leukemia

Long non-coding RNAs (lncRNAs) are pivotal players in cellular processes, and their unique cell-type specific expression patterns render them attractive biomarkers and therapeutic targets. Yet, the functional ...

Reduced interleukin-18 secretion by human monocytic cells in response to infections with hyper-virulent Streptococcus pyogenes

Streptococcus pyogenes (group A streptococcus, GAS) causes a variety of diseases ranging from mild superficial infections of the throat and skin to severe invasive infections, such as necrotizing soft tissue infe...

Metabolism-regulating non-coding RNAs in breast cancer: roles, mechanisms and clinical applications

Breast cancer is one of the most common malignancies that pose a serious threat to women's health. Reprogramming of energy metabolism is a major feature of the malignant transformation of breast cancer. Compar...

Genetic and pharmacologic p32-inhibition rescue CHCHD2-linked Parkinson’s disease phenotypes in vivo and in cell models

Mutations in CHCHD2 have been linked to Parkinson’s disease, however, their exact pathophysiologic roles are unclear. The p32 protein has been suggested to interact with CHCHD2, however, the physiological functio...

The role of pregnancy associated plasma protein-A in triple negative breast cancer: a promising target for achieving clinical benefits

Pregnancy associated plasma protein-A (PAPP-A) plays an integral role in breast cancer (BC), especially triple negative breast cancer (TNBC). This subtype accounts for the most aggressive BC, possesses high tu...

Translational research on drug development and biomarker discovery for hepatocellular carcinoma

Translational research plays a key role in drug development and biomarker discovery for hepatocellular carcinoma (HCC). However, unique challenges exist in this field because of the limited availability of hum...

Germline mutations of homologous recombination genes and clinical outcomes in pancreatic cancer: a multicenter study in Taiwan

Cancer susceptibility germline mutations are associated with pancreatic ductal adenocarcinoma (PDAC). However, the hereditary status of PDAC and its impact on survival is largely unknown in the Asian population.

Rab37 mediates trafficking and membrane presentation of PD-1 to sustain T cell exhaustion in lung cancer

Programmed cell death protein 1 (PD-1) is an immune checkpoint receptor expressed on the surface of T cells. High expression of PD-1 leads to T-cell dysfunction in the tumor microenvironment (TME). However, th...

FLT3L-induced virtual memory CD8 T cells engage the immune system against tumors

Previous research in FMS-like tyrosine kinase 3 ligands (FLT3L) has primarily focused on their potential to generate dendritic cells (DCs) from bone marrow progenitors, with a limited understanding of how thes...

Promising antibacterial efficacy of arenicin peptides against the emerging opportunistic pathogen Mycobacterium abscessus

Mycobacterium abscessus , a fast-growing non-tuberculous mycobacterium, is an emerging opportunistic pathogen responsible for chronic bronchopulmonary infections in people with respiratory diseases such as cystic ...

Targeting MDM2 in malignancies is a promising strategy for overcoming resistance to anticancer immunotherapy

MDM2 has been established as a biomarker indicating poor prognosis for individuals undergoing immune checkpoint inhibitor (ICI) treatment for different malignancies by various pancancer studies. Specifically, ...

Mechanisms and functions of SUMOylation in health and disease: a review focusing on immune cells

SUMOylation, which is a type of post-translational modification that involves covalent conjugation of small ubiquitin-like modifier (SUMO) proteins to target substrates, regulates various important molecular a...

Hesperetin activates CISD2 to attenuate senescence in human keratinocytes from an older person and rejuvenates naturally aged skin in mice

CDGSH iron-sulfur domain-containing protein 2 (CISD2), a pro-longevity gene, mediates healthspan in mammals. CISD2 is down-regulated during aging. Furthermore, a persistently high level of CISD2 promotes longe...

Plectin plays a role in the migration and volume regulation of astrocytes: a potential biomarker of glioblastoma

The expression of aquaporin 4 (AQP4) and intermediate filament (IF) proteins is altered in malignant glioblastoma (GBM), yet the expression of the major IF-based cytolinker, plectin (PLEC), and its contributio...

Modelling the complex nature of the tumor microenvironment: 3D tumor spheroids as an evolving tool

Cancer remains a serious burden in society and while the pace in the development of novel and more effective therapeutics is increasing, testing platforms that faithfully mimic the tumor microenvironment are l...

TEM1/endosialin/CD248 promotes pathologic scarring and TGF-β activity through its receptor stability in dermal fibroblasts

Pathologic scars, including keloids and hypertrophic scars, represent a common form of exaggerated cutaneous scarring that is difficult to prevent or treat effectively. Additionally, the pathobiology of pathol...

Physiology and pharmacological targeting of phase separation

Liquid–liquid phase separation (LLPS) in biology describes a process by which proteins form membraneless condensates within a cellular compartment when conditions are met, including the concentration and postt...

Inactivation of pentraxin 3 suppresses M2-like macrophage activity and immunosuppression in colon cancer

The tumor microenvironment is characterized by inflammation-like and immunosuppression situations. Although cancer-associated fibroblasts (CAFs) are among the major stromal cell types in various solid cancers,...

Engineered EVs with pathogen proteins: promising vaccine alternatives to LNP-mRNA vaccines

Extracellular vesicles (EVs) are tiny, lipid membrane-bound structures that are released by most cells. They play a vital role in facilitating intercellular communication by delivering bioactive cargoes to rec...

Attenuation of neurovirulence of chikungunya virus by a single amino acid mutation in viral E2 envelope protein

Chikungunya virus (CHIKV) has reemerged as a major public health concern, causing chikungunya fever with increasing cases and neurological complications.

Scaffold-based 3D cell culture models in cancer research

Three-dimensional (3D) cell cultures have emerged as valuable tools in cancer research, offering significant advantages over traditional two-dimensional (2D) cell culture systems. In 3D cell cultures, cancer c...

Therapeutic antibodies for the prevention and treatment of cancer

The developments of antibodies for cancer therapeutics have made remarkable success in recent years. There are multiple factors contributing to the success of the biological molecule including origin of the an...

Immune evasion in cell-based immunotherapy: unraveling challenges and novel strategies

Cell-based immunotherapies (CBIs), notably exemplified by chimeric antigen receptor (CAR)-engineered T (CAR-T) cell therapy, have emerged as groundbreaking approaches for cancer therapy. Nevertheless, akin to ...

Exploring the relationship between metabolism and immune microenvironment in osteosarcoma based on metabolic pathways

Metabolic remodeling and changes in tumor immune microenvironment (TIME) in osteosarcoma are important factors affecting prognosis and treatment. However, the relationship between metabolism and TIME needs to ...

The synergism of cytosolic acidosis and reduced NAD + /NADH ratio is responsible for lactic acidosis-induced vascular smooth muscle cell impairment in sepsis

During sepsis, serve vascular dysfunctions lead to life-threatening multiple organ failure, due to vascular smooth muscle cells (VSMC) impairments, resulting in vasoplegia, hypotension and hypoperfusion. In ad...

Localization, traffic and function of Rab34 in adipocyte lipid and endocrine functions

Excessive lipid accumulation in the adipose tissue in obesity alters the endocrine and energy storage functions of adipocytes. Adipocyte lipid droplets represent key organelles coordinating lipid storage and m...

Nano-modified viruses prime the tumor microenvironment and promote the photodynamic virotherapy in liver cancer

As of 2020, hepatocellular carcinoma (HCC), a form of liver cancer, stood as the third most prominent contributor to global cancer-related mortality. Combining immune checkpoint inhibitors (ICI) with other the...

A novel mucosal bivalent vaccine of EV-A71/EV-D68 adjuvanted with polysaccharides from Ganoderma lucidum protects mice against EV-A71 and EV-D68 lethal challenge

Human enteroviruses A71 (EV-A71) and D68 (EV-D68) are the suspected causative agents of hand-foot-and-mouth disease, aseptic meningitis, encephalitis, acute flaccid myelitis, and acute flaccid paralysis in chi...

A secreted form of chorismate mutase (Rv1885c) in Mycobacterium bovis BCG contributes to pathogenesis by inhibiting mitochondria-mediated apoptotic cell death of macrophages

Mycobacterium tuberculosis is the causative agent of tuberculosis (TB), and its pathogenicity is associated with its ability to evade the host defense system. The secretory form of the chorismate mutase of M. tub...

ARID1A loss activates MAPK signaling via DUSP4 downregulation

ARID1A , a tumor suppressor gene encoding BAF250, a protein participating in chromatin remodeling, is frequently mutated in endometrium-related malignancies, including ovarian or uterine clear cell carcinoma (CCC)...

SCEL regulates switches between pro-survival and apoptosis of the TNF-α/TNFR1/NF-κB/c-FLIP axis to control lung colonization of triple negative breast cancer

Patients with metastatic triple-negative breast cancer (mTNBC) have a higher probability of developing visceral metastasis within 5 years after the initial diagnosis. Therefore, a deeper understanding of the p...

Butterflies in the gut: the interplay between intestinal microbiota and stress

Psychological stress is a global issue that affects at least one-third of the population worldwide and increases the risk of numerous psychiatric disorders. Accumulating evidence suggests that the gut and its ...

Spatiotemporal roles of AMPK in PARP-1- and autophagy-dependent retinal pigment epithelial cell death caused by UVA

Although stimulating autophagy caused by UV has been widely demonstrated in skin cells to exert cell protection, it remains unknown the cellular events in UVA-treated retinal pigment epithelial (RPE) cells.

The ‘speck’-tacular oversight of the NLRP3-pyroptosis pathway on gastrointestinal inflammatory diseases and tumorigenesis

The NLRP3 inflammasome is an intracellular sensor and an essential component of the innate immune system involved in danger recognition. An important hallmark of inflammasome activation is the formation of a s...

Complete spectrum of adverse events associated with chimeric antigen receptor (CAR)-T cell therapies

Chimeric antigen receptor (CAR)-T cell therapies have been approved by FDA to treat relapsed or refractory hematological malignancies. However, the adverse effects of CAR-T cell therapies are complex and can b...

Small interfering RNA (siRNA)-based therapeutic applications against viruses: principles, potential, and challenges

RNA has emerged as a revolutionary and important tool in the battle against emerging infectious diseases, with roles extending beyond its applications in vaccines, in which it is used in the response to the CO...

Human ACE2 protein is a molecular switch controlling the mode of SARS-CoV-2 transmission

Human angiotensin-converting enzyme 2 (hACE2) is the receptor mediating severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. hACE2 expression is low in the lungs and is upregulated after SAR...

Crosstalk between mitochondrial biogenesis and mitophagy to maintain mitochondrial homeostasis

Mitochondrial mass and quality are tightly regulated by two essential and opposing mechanisms, mitochondrial biogenesis (mitobiogenesis) and mitophagy, in response to cellular energy needs and other cellular a...

Extracellular release in the quality control of the mammalian mitochondria

Mammalian cells release a wealth of materials to their surroundings. Emerging data suggest these materials can even be mitochondria with perturbed morphology and aberrant function. These dysfunctional mitochon...

mRNA-based vaccines and therapeutics: an in-depth survey of current and upcoming clinical applications

mRNA-based drugs have tremendous potential as clinical treatments, however, a major challenge in realizing this drug class will promise to develop methods for safely delivering the bioactive agents with high e...

Clinical trials of new drugs for Alzheimer disease: a 2020–2023 update

Alzheimer's disease (AD) is the leading cause of dementia, presenting a significant unmet medical need worldwide. The pathogenesis of AD involves various pathophysiological events, including the accumulation o...

Induced pluripotent stem cells: ex vivo models for human diseases due to mitochondrial DNA mutations

Mitochondria are essential organelles for cellular metabolism and physiology in eukaryotic cells. Human mitochondria have their own genome (mtDNA), which is maternally inherited with 37 genes, encoding 13 poly...

Interaction of the AKT and β-catenin signalling pathways and the influence of photobiomodulation on cellular signalling proteins in diabetic wound healing

The induction of a cells destiny is a tightly controlled process that is regulated through communication between the matrix and cell signalling proteins. Cell signalling activates distinctive subsections of ta...

LncRNA SLCO4A1-AS1 suppresses lung cancer progression by sequestering the TOX4-NTSR1 signaling axis

Metastasis is a multistep process involving the migration and invasion of cancer cells and is a hallmark of cancer malignancy. Long non-coding RNAs (lncRNAs) play critical roles in the regulation of metastasis...

Expanding applications of allogeneic platelets, platelet lysates, and platelet extracellular vesicles in cell therapy, regenerative medicine, and targeted drug delivery

Platelets are small anucleated blood cells primarily known for their vital hemostatic role. Allogeneic platelet concentrates (PCs) collected from healthy donors are an essential cellular product transfused by ...

Long noncoding RNA SNHG16 regulates TLR4-mediated autophagy and NETosis formation in alveolar hemorrhage associated with systemic lupus erythematosus

Dysregulated long noncoding RNA (lncRNA) expression with increased apoptosis has been demonstrated in systemic lupus erythematosus (SLE) patients with alveolar hemorrhage (AH). SNHG16, a lncRNA, can enhance pu...

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Biomedical Research Paper Topics

This page offers students an extensive list of biomedical research paper topics , expert advice on how to choose these topics, and guidance on how to write a compelling biomedical research paper. The guide also introduces the services of iResearchNet, an academic assistance company that caters to the unique needs of each student. Offering expert writers, custom-written works, and a host of other features, iResearchNet provides the tools and support necessary for students to excel in their biomedical research papers.

100 Biomedical Research Paper Topics

Biomedical research is a vibrant field, with an extensive range of topics drawn from various sub-disciplines. It encompasses the study of biological processes, clinical medicine, and even technology and engineering applied to the domain of healthcare. Given the sheer breadth of this field, choosing a specific topic can sometimes be overwhelming. To help you navigate this rich landscape, here is a list of biomedical research paper topics, divided into ten categories, each with ten specific topics.

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1. Genetics and Genomics

• Role of genetics in rare diseases
• Advances in gene editing: CRISPR technology
• Human genome project: findings and implications
• Genetic basis of cancer
• Personalized medicine through genomics
• Epigenetic modifications and disease progression
• Genomic data privacy and ethical implications
• Role of genetics in mental health disorders
• Prenatal genetic screening and ethical considerations
• Gene therapy in rare genetic disorders

2. Bioengineering and Biotechnology

• Tissue engineering in regenerative medicine
• Bioprinting of organs: possibilities and challenges
• Role of nanotechnology in targeted drug delivery
• Biosensors in disease diagnosis
• Bioinformatics in drug discovery
• Development and application of biomaterials
• Bioremediation and environmental cleanup
• Biotechnology in agriculture and food production
• Therapeutic applications of stem cells
• Role of biotechnology in pandemic preparedness

3. Neuroscience and Neurology

• Pathophysiology of Alzheimer’s disease
• Advances in Parkinson’s disease research
• Role of neuroimaging in mental health diagnosis
• Understanding the brain-gut axis
• Neurobiology of addiction
• Role of neuroplasticity in recovery from brain injury
• Sleep disorders and cognitive function
• Brain-computer interfaces: possibilities and ethical issues
• Neural correlates of consciousness
• Epigenetic influence on neurodevelopmental disorders

4. Immunology

• Immune response to COVID-19
• Role of immunotherapy in cancer treatment
• Autoimmune diseases: causes and treatments
• Vaccination and herd immunity
• The hygiene hypothesis and rising allergy prevalence
• Role of gut microbiota in immune function
• Immunosenescence and age-related diseases
• Role of inflammation in chronic diseases
• Advances in HIV/AIDS research
• Immunology of transplantation

5. Cardiovascular Research

• Advances in understanding and treating heart failure
• Role of lifestyle factors in cardiovascular disease
• Cardiovascular disease in women
• Hypertension: causes and treatments
• Pathophysiology of atherosclerosis
• Role of inflammation in heart disease
• Novel biomarkers for cardiovascular disease
• Personalized medicine in cardiology
• Advances in cardiac surgery
• Pediatric cardiovascular diseases

6. Infectious Diseases

• Emerging and re-emerging infectious diseases
• Role of antiviral drugs in managing viral diseases
• Antibiotic resistance: causes and solutions
• Zoonotic diseases and public health
• Role of vaccination in preventing infectious diseases
• Infectious diseases in immunocompromised individuals
• Role of genomic sequencing in tracking disease outbreaks
• HIV/AIDS: prevention and treatment
• Advances in malaria research
• Tuberculosis: challenges in prevention and treatment

7. Aging Research

• Biological mechanisms of aging
• Impact of lifestyle on healthy aging
• Age-related macular degeneration
• Role of genetics in longevity
• Aging and cognitive decline
• Social aspects of aging
• Advances in geriatric medicine
• Aging and the immune system
• Role of physical activity in aging
• Aging and mental health

8. Endocrinology

• Advances in diabetes research
• Obesity: causes and health implications
• Thyroid disorders: causes and treatments
• Role of hormones in mental health
• Endocrine disruptors and human health
• Role of insulin in metabolic syndrome
• Advances in treatment of endocrine disorders
• Hormones and cardiovascular health
• Reproductive endocrinology
• Role of endocrinology in aging

9. Mental Health Research

• Advances in understanding and treating depression
• Impact of stress on mental health
• Advances in understanding and treating schizophrenia
• Child and adolescent mental health
• Mental health in the elderly
• Impact of social media on mental health
• Suicide prevention and mental health services
• Role of psychotherapy in mental health
• Mental health disparities

10. Oncology

• Advances in cancer immunotherapy
• Role of genomics in cancer diagnosis and treatment
• Lifestyle factors and cancer risk
• Early detection and prevention of cancer
• Advances in targeted cancer therapies
• Role of radiation therapy in cancer treatment
• Cancer disparities and social determinants of health
• Pediatric oncology: challenges and advances
• Role of stem cells in cancer
• Cancer survivorship and quality of life

These biomedical research paper topics represent a wide array of studies within the field of biomedical research, providing a robust platform to delve into the intricacies of human health and disease. Each topic offers a unique opportunity to explore the remarkable advancements in biomedical research, contributing to the ongoing quest to enhance human health and wellbeing.

Choosing Biomedical Research Paper Topics

The selection of a suitable topic for your biomedical research paper is a critical initial step that will largely influence the course of your study. The right topic will not only engage your interest but will also be robust enough to contribute to the existing body of knowledge. Here are ten tips to guide you in choosing the best topic for your biomedical research paper.

• Relevance to Your Coursework and Interests: Your topic should align with the courses you have taken or are currently enrolled in. Moreover, a topic that piques your interest will motivate you to delve deeper into research, resulting in a richer, more nuanced paper.
• Feasibility: Consider the practicality of your proposed research. Do you have access to the necessary resources, including the literature, laboratories, or databases needed for your study? Ensure that your topic is one that you can manage given your resources and time constraints.
• Novelty and Originality: While it is essential to ensure your topic aligns with your coursework and is feasible, strive to select a topic that brings a new perspective or fresh insight to your field. Originality enhances the contribution of your research to the broader academic community.
• Scope: A well-defined topic helps maintain a clear focus during your research. Avoid choosing a topic too broad that it becomes unmanageable, or so narrow that it lacks depth. Balancing the scope of your research is key to a successful paper.
• Future Career Goals: Consider how your chosen topic could align with or benefit your future career goals. A topic related to your future interests can provide an early start to your career, showcasing your knowledge in that particular field.
• Available Supervision and Mentoring: If you’re in a setting where you have a mentor or supervisor, choose a topic that fits within their area of expertise. This choice will ensure you have the best possible guidance during your research process.
• Ethical Considerations: Some topics may involve ethical considerations, particularly those involving human subjects, animals, or sensitive data. Make sure your topic is ethically sound and you’re prepared to address any related ethical considerations.
• Potential Impact: Consider the potential impact of your research on the field of biomedical science. The best research often addresses a gap in the current knowledge or has the potential to bring about change in healthcare practices or policies.
• Literature Gap: Literature review can help identify gaps in the existing body of knowledge. Choosing a topic that fills in these gaps can make your research more valuable and unique.
• Flexibility: While it’s essential to start with a clear topic, remain open to slight shifts or changes as your research unfolds. Your research might reveal a different angle or a more exciting question within your chosen field, so stay flexible.

Remember, choosing a topic should be an iterative process, and your initial ideas will likely evolve as you conduct a preliminary literature review and discuss your thoughts with your mentors or peers. The ultimate goal is to choose a topic that you are passionate about, as this passion will drive your work and make the research process more enjoyable and fulfilling.

How to Write a Biomedical Research Paper

Writing a biomedical research paper can be a daunting task. However, with careful planning and strategic execution, the process can be more manageable and rewarding. Below are ten tips to help guide you through the process of writing a biomedical research paper.

• Understand Your Assignment: Before you begin your research or writing, make sure you understand the requirements of your assignment. Know the expected length, due date, formatting style, and any specific sections or components you need to include.
• Thorough Literature Review: A comprehensive literature review allows you to understand the current knowledge in your research area and identify gaps where your research can contribute. It will help you shape your research question and place your work in context.
• Clearly Define Your Research Question: A well-defined research question guides your research and keeps your writing focused. It should be clear, specific, and concise, serving as the backbone of your study.
• Prepare a Detailed Outline: An outline helps organize your thoughts and create a roadmap for your paper. It should include all the sections of your research paper, such as the introduction, methods, results, discussion, and conclusion.
• Follow the IMRaD Structure: Most biomedical research papers follow the IMRaD format—Introduction, Methods, Results, and Discussion. This structure facilitates the orderly and logical presentation of your research.
• Use Clear and Concise Language: Biomedical research papers should be written in a clear and concise manner to ensure the reader understands the research’s purpose, methods, and findings. Avoid unnecessary jargon and ensure that complex ideas are explained clearly.
• Proper Citation and Reference: Always properly cite the sources of information you use in your paper. This not only provides credit where it’s due but also allows your readers to follow your line of research. Be sure to follow the citation style specified in your assignment.
• Discuss the Implications: In your discussion, go beyond simply restating your findings. Discuss the implications of your results, how they relate to previous research, and how they contribute to the existing knowledge in the field.
• Proofread and Edit: Never underestimate the importance of proofreading and editing. Checking for grammatical errors, punctuation mistakes, and clarity of language can enhance the readability of your paper.
• Seek Feedback Before Final Submission: Before submitting your paper, seek feedback from peers, mentors, or supervisors. Fresh eyes can often spot unclear sections or errors that you may have missed.

Writing a biomedical research paper is a significant academic endeavor, but remember that every researcher started where you are right now. It’s a process that requires time, effort, and patience. Remember, the ultimate goal is not just to get a good grade but also to contribute to the vast body of biomedical knowledge.

iResearchNet’s Custom Writing Services

Navigating the process of writing a biomedical research paper can be complex and demanding. At iResearchNet, we understand these challenges and strive to offer a stress-free, seamless solution to support your academic journey. With our roster of highly skilled, degree-holding writers, we are committed to delivering top-quality, custom-written papers tailored specifically to your individual requirements and desired outcomes.

• Expert Degree-Holding Writers: iResearchNet takes pride in our team of knowledgeable and experienced writers who hold advanced degrees in diverse fields. These writers are not only academic experts but are also keenly in tune with the complex landscape of biomedical research. This breadth and depth of expertise ensure that your paper benefits from a thorough understanding of the topic, resulting in a well-informed, academically credible document.
• Custom Written Works: We appreciate the unique academic goals and distinct requirements of each student. That’s why iResearchNet specializes in providing custom-written papers. Our aim is to capture your individual academic voice and perspective, blending it with our professional acumen to create a paper that reflects your specific academic needs and aspirations.
• In-Depth Research: Every paper that we produce is founded on the bedrock of extensive and in-depth research. Our writers are committed to exploring a wide range of credible and reputable sources to enrich your paper with diverse viewpoints and comprehensive information. This dedication to rigorous research ensures that your paper is not only thoroughly informed but also accurately referenced, adding to its academic integrity.
• Custom Formatting: Academic institutions often require different formatting styles. Be it APA, MLA, Chicago/Turabian, or Harvard, our writers are adept at all these academic formatting styles. We strive to adhere strictly to your specified formatting style, contributing to the polished and professional presentation of your paper.
• Top Quality: Quality is the cornerstone of our services at iResearchNet. We believe that each paper we craft should demonstrate a high standard of scholarship. Our writers dedicate their skills and effort to ensure every aspect of your paper, from clarity of language to depth of analysis and precision of information, reflects top-quality work.
• Customized Solutions: Recognizing that each research paper brings a distinct set of challenges and requirements, we offer customized solutions. Our approach is to thoroughly understand your specific needs and shape our writing services accordingly. We ensure that every aspect of your paper, from its overarching structure to the smallest details, aligns with your expectations.
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• Timely Delivery: At iResearchNet, we understand the critical importance of adhering to deadlines in the academic world. We commit to the timely delivery of all orders, ensuring that you are always able to submit your work on time. With our service, you can put aside worries about late submissions.
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• Money Back Guarantee: Your satisfaction is our ultimate goal. We strive to meet your expectations, but if for any reason the final work falls short, we offer a money-back guarantee. This policy is a testament to our confidence in the quality of our services and our commitment to your academic success.

At iResearchNet, we strive to be more than just a writing service provider. We aspire to be a trusted academic partner, providing support and expertise to help you navigate the complexities of writing a biomedical research paper. With our combination of expert knowledge, high commitment to quality, and excellent customer service, we are the ideal choice for all your academic writing needs.

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• Perspective
• Published: 22 March 2024

Recommendations for the responsible use and communication of race and ethnicity in neuroimaging research

• Carlos Cardenas-Iniguez   ORCID: orcid.org/0000-0002-6736-3020 1 &
• Marybel Robledo Gonzalez 2  

Nature Neuroscience ( 2024 ) Cite this article

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• Cognitive neuroscience
• Research data

The growing availability of large-population human biomedical datasets provides researchers with unique opportunities to conduct rigorous and impactful studies on brain and behavioral development, allowing for a more comprehensive understanding of neurodevelopment in diverse populations. However, the patterns observed in these datasets are more likely to be influenced by upstream structural inequities (that is, structural racism), which can lead to health disparities based on race, ethnicity and social class. This paper addresses the need for guidance and self-reflection in biomedical research on conceptualizing, contextualizing and communicating issues related to race and ethnicity. We provide recommendations as a starting point for researchers to rethink race and ethnicity choices in study design, model specification, statistical analysis and communication of results, implement practices to avoid the further stigmatization of historically minoritized groups, and engage in research practices that counteract existing harmful biases.

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Acknowledgements

We thank the large number of people who provided feedback, comments and critiques over the development of this paper. In particular, we thank the members of the ABCD Study JEDI Working Groups, who provided many of the initial discussions that led to the development of this paper. We particularly acknowledge the following people for providing numerous comments on drafts of this manuscript: M. Herting, K. Bagot, L. Uddin, S. Bodison, R. Huber, D. Lopez, E. Hoffman, S. Adise, A. Potter and K. Uban. C.C.-I. acknowledges fellow NSP (R25NS089462), BRAINS (R25NS094094) and Diversifying CNS (R25NS117356) scholars, who have provided invaluable support and inspiration for addressing structural barriers in neuroscience for BIPOC scholars, as well as T32ES013678, R25DA059073, and R25MH125545. C.C.-I. is supported by National Institute of Environmental Health Science grants T32ES013678, R01ES031074 and P30ES007048, and National Institute on Minority Health and Health Disparities grant P50MD015705. M.R.G. is supported by National Institute on Alcohol Abuse and Alcoholism grant K01AA030325 and National Institute on Drug Abuse grants R61DA058976, R25DA050724, and R25DA050687.

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C.C.-I. wrote the first draft of the manuscript. M.R.G. wrote sections of the manuscript. All authors contributed to the revision of the paper and approved the submitted version.

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Cardenas-Iniguez, C., Gonzalez, M.R. Recommendations for the responsible use and communication of race and ethnicity in neuroimaging research. Nat Neurosci (2024). https://doi.org/10.1038/s41593-024-01608-4

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The landscape of biomedical research

This interactive visualization displays 21 million scientific papers collected in the PubMed database , maintained by the United States National Library of Medicine and encompassing all biomedical and life science fields of research.

You can scroll the narration in the left part of the screen, and interact with the visualization in the right part of the screen. Zooming in loads additional papers. Information about each individual paper appears on mouse-over, and clicking on a paper opens its PubMed page in a separate window. Search over titles is available in the upper-right corner.

Scroll down to read more!

And see our paper for more details.

Introduction

Over one million articles are being currently published every year in biomedicine and life sciences. The sheer amount of publications makes it difficult to track the evolution of biomedical publishing as a whole. Search engines like PubMed and Google Scholar allow to find specific papers given suitable keywords and follow the citation networks that these papers are embedded in, yet none of them allows to explore the biomedical literature ‘landscape’ from a global perspective. This makes it hard to see how research topics evolve over time, how different fields are related to each other, or how new methods and techniques are adopted in different fields.

To answer such questions, we provide a bird’s-eye view on the biomedical literature.

Here we offer an approach that enables all of the above: a global two-dimensional atlas of the biomedical and life science literature which is based on the abstracts of all 21 million English language articles contained in the PubMed database. To create the map, we embedded the abstracts into two dimensions using the transformer-based large language model PubMedBERT combined with the neighbor embedding method t-SNE .

Our map is based on the abstract texts alone, and did not use any further metadata or information on citations or references.

This visualization facilitates exploration of the biomedical literature and can reveal aspects of the data that would not be easily noticed with other analysis methods. We showcase the power of our approach in four examples:

• The emergence of the Covid-19 literature.
• The evolution of different subfields of neuroscience
• The uptake of machine learning (upcoming; see paper)
• The distribution of gender imbalance across biomedical fields.

The shared strategy in all of these is to formulate specific hypotheses about the data based on the visual exploration, and then to confirm them by a dedicated statistical analysis of the original high-dimensional dataset.

We labeled the dataset by selecting 38 keywords contained in journal titles that reflected the general topic of the paper. We based our choice of keywords on lists of medical specialties and life science branches that appeared frequently in the journal titles in our dataset.

Papers were assigned a label if their journal title contained that term. As a result, about a third of the papers in the dataset received labels.

The labels demonstrate that our map has sensible global organization: psychology papers are next to psychiatry papers, optics is next to physics , and so on. Overall, the left part of the map corresponds to life sciences, while the right part corresponds to medicine.

The global structure is well captured by categories assigned based on subject headings by the iCite project . These measures look at all MeSH headings and classify each article by the share that is related to humans, to molecular biology, or to animal studies. The right half of the chart is human medicine, while the left half is split between animal and biochemical studies.

While we use journal titles to assign labels, the actual data underlying this representation are abstract texts . Here we color the map by length of each abstract (darker color: shorter abstracts; lighter color: longer abstracts). This, too, shows regional patterns, with some disciplines preferring longer abstracts than others.

Abstract lengths do not obey a smooth distribution: instead, they cluster at 150, 200, and 250 words, likely because authors are constrained by journals’ submission guidelines.

The majority of the displayed papers were published between 1970 and 2021. Here darker colors correspond to earlier publication years and lighter colors correspond to more recent papers.

Our map, however, is not predominantly organized by time. Most regions contain articles from multiple different eras in fairly close proximity.

But when zooming in closer, temporal periods often become well segregated. In most individual fields, the temporal division is very strong: for example, here we see that science progresses within immunology and virology in such a way that recent articles have abstracts much more similar to each other than to articles from the 1970s and 1980s in the same fields.

Strikingly, one area of the map contains only papers from 2020–21. These are papers on Covid-19.

We considered a paper Covid-related if it contained phrases like “Covid-19” or “SARS-CoV-2” in the abstract text. Our dataset includes 132 thousand Covid-related papers, most of which are concentrated in this area.

See our paper for direct evidence that Covid literature formed an unprecedentally tight research cluster.

We can group the Covid papers based on the presence of specific keywords in their title. All different kinds of Covid-related research appear in this cluster in microcosm, from treatment and epidemiology at the top, to social and family-related issues at the bottom.

Vaccines appear as two major regions which are completely distinct: one involving the scientific effort to create and test vaccines, and the other (towards the bottom) involving the public health effort to get people to use the vaccines once they were widely available.

We can also see how the focus of Covid publications shifted with time during 2020–2021. Early papers are predominantly clinical, while research on societal implications and vaccine hesitancy appeared later.

Neuroscience

Neuroscience papers congeal into two large regions of the map: one in the upper part, and one in the lower part.

Coloring neuroscience papers by some of the prominent terms appearing in their titles, we see that the upper part encompasses research on cellular and molecular neuroscience, whereas the lower part contains literature on behavioural and computational neuroscience.

Coloring papers by publication year suggests that neuroscience originated as a study of cellular and molecular mechanisms, and later broadened to include behavioural and computational research.

See direct quantifications of this effect in our paper.

Gender bias

Using the first name of the first author of each paper, we could infer their gender. Coloring the map with the inferred gender, we can see which research fields have more male or female authors.

Some areas are dominated by either female or male first authors. Here are some examples:

In some individual disciplines we saw substantial heterogeneity of gender ratios. For example, there were male- and female-dominated regions in the map of healthcare papers. One of the more male-dominated clusters focused on financial management while one of the more female ones – on patient care.

In education, female authors dominated research on nursing training; male authors were more frequent in research on medical training.

In surgery, only 24% of the first authors were female, but this fraction increased to 61% in the cluster of papers on veterinary surgery.

Retractions

Text similarity metrics like these offer potentially useful methods for identifying large-scale patterns. Several specific areas, in particular on top of the map, covering research on cancer-related drugs, marker genes, and microRNA. These areas are known targets of paper mills, which are for-profit organizations that produce fraudulent research papers and sell the authorship.

In the paper we investigate this region with particularly high fraction (48/443) of retracted papers. Most other papers in this area have similar title format (variations of “MicroRNA- X does Y by targeting Z in osteosarcoma”), paper structure, and figure style, and 24/25 of them had authors affiliated with Chinese hospitals (some of which provide promotions or pay increases for publications without providing substantial laboratory support).

Regions like this merit closer attention.

Linking data

Pubmed IDs are universal identifiers that allow for various other integrations with our map. Right now, for example, we display citation counts for each paper.

Search using PubMed APIs

If you have a specific list of pubmed ids separated by commas, spaces, or newlines (or any combination) you can enter them into the searchbox below to highlight them on the map. Note that you may need to zoom in to see all the points.

Alter point sizes for selected and unselected points.

BERT model vs. TF-IDF

We also produced a two-dimensional map based on the bag-of-words representation of PubMed abstracts (known in the natural language processing literature as TF-IDF) instead of the PubMedBERT model. This resulted in worse separation between our journal-based labels, so used the PubMedBERT approach for all the visualizations above. Please see the paper for more detailed comparison.

Here you can switch between the PubMedBERT-based and the TF-IDF-based maps.

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An overview for biomedical waste management during pandemic like COVID-19

• Published: 06 June 2022
• Volume 20 , pages 8025–8040, ( 2023 )

Cite this article

• V. S. Kanwar 1 ,
• A. Sharma 1 ,
• M. Kanwar ,
• A. L. Srivastav   ORCID: orcid.org/0000-0003-0238-7395 1 &
• D. K. Soni 3  

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Amid COVID-19, world has gone under environmental reformation in terms of clean rivers and blue skies, whereas, generation of biomedical waste management has emerged as a big threat for the whole world, especially in the developing nations. Appropriate biomedical waste management has become a prime concern worldwide in the pandemic era of COVID-19 as it may affect environment and living organisms up to a great extent. The problem has been increased many folds because of unexpected generations of hazardous biomedical waste which needs extraordinary attentions. In this paper, the impacts and future challenges of solid waste management especially the biomedical waste management on environment and human beings have been discussed amid COVID-19 pandemic. The paper also recommends some guidelines to manage the bulk of medical wastes for the protection of human health and environment. The paper summarizes better management practices for the wastes including optimizing the decision process, infrastructure, upgrading treatment methods and other activities related with the biological disasters like COVID-19. As achieved in the past for viral disinfection, use of UV- rays with proper precautions can also be explored for COVID-19 disinfection. For biomedical waste management, thermal treatment of waste can be an alternative, as it can generate energy along with reducing waste volume by 80–95%. The Asian Development Bank observed that additional biomedical waste was generated ranged from 154 to 280 tons/day during the peak of COVID-19 pandemic in Asian megacities such as Manila, Jakarta, Wuhan, Bangkok, Hanoi, Kuala Lumpur.

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Introduction

COVID-19 (or Coronavirus disease 2019) originated from the animals (meat/fisheries market of the Wuhan city, China) can cause severe infections to the human respiration system (Cascella et al. 2020 ; Roujian et al. 2020 ; Zhu et al. 2020 ; Xu et al. 2020 ). Firstly, it was diagnosed in the end of December, 2019 in Wuhan city of China when like pneumonia symptoms were observed in the local residents of Wuhan (WHO 2020a ; Lokhandwala and Gautam 2020 ; Sohrabi et al. 2020 ). Other health problems were also got detected because of CIVID-19 infections including breath shortness, fever, pain in muscles and head (Huang et al. 2020 ). WHO declared worldwide human health emergency (pandemic) due to fast rate of COVID-19 infections as it took around 3 months durations only to reach in 100 nations. Moreover, 10 million people of the world got infected with COVID-19 till the last of May, 2020, whereas up to last week of June, 2020, COVID-19 infections reached in 216 countries (WHO 2020b ). Even top economic nations of the world (USA, Germany, France, Spain, Japan, Singapore, Italy etc.) were stuck in the raising COVID-19 infections among the community people (Amanat and Krammer 2020 ). However, USA was and still on the top in terms of highest numbers of both infections and deaths due this pandemic (CDC 2020 ). In Asia, India is on the top position reading deaths as well infections due to corona virus (MoHFW 2020 ). In the absence of vaccine, testing of COVID-19 has become very important to prevent its further infections and reverse-transcription polymerase chain reaction, medical imaging and computed tomography are the recommended methods of detection (Ardakani et al. 2020 ). Despite of infecting huge population, the fatality rate of COVID-19in India is less than Middle East respiratory syndrome (MERS, year 2012) and severe acute respiratory syndrome (SARS CoV-1 year 2003) and more than the Spanish flu (year 1918) as shown in Fig.  1 .

Source : Modified from Goel et al. 2020 )

Human fatality rates of different viral infections (

From Fig.  1 , it was observed that in year 2012, MERS had affected people of 27 countries of the world with maximum fatality rate of 34.3% followed by SARS CoV-1 in year 2003 with 15%. In 1918, the fatality rate of Spanish flu was rescored as 10% which is less than COVID-19 (12.3%) (Callaway et al. 2020 ; Goel et al. 2020 ). However, according to Gates ( 2020 ), it can kill only 1% of total infected persons including old aged people as well as adults, if they were already suffering with some serious health disorders. However, it can spread easily among the humans as compared to other illness (Goel et al. 2020 ). Because of this reason, initially, rate of infection was slow and later through community transmission; it has reached in every part of the world (Anderson et al. 2020 ; Shammi et al. 2020 ).

Factors responsible for the transmission of COVID-19

As per the studies, it has been found that several days are required for complete inactivation of COVID-19 virus (Casanova et al. 2009 ; Qu et al. 2020 ). It is quite evident corona virus is mostly spreading through physical contacts between the individuals knowingly or unknowingly. However, it can also infect the healthy people through the skin, mouth, nose and eyes of any COVID-19 patient after direct or indirect interactions. The virus can survive on the various types of surfaces (medical wastes, plastic etc.) or environment for a specific time (Weber et al. 2016 ; Qu et al. 2020 ). Further, the chances of viral infection may be governed by several factors including stability of virus containing aerosols in the air (usually 3 h is reported), active periods of the virus on the surfaces like steel (7 days), glasses and currency papers (4 days). Even after applying soap on the hands, additional five minutes are required to inactivate the virus. Hence, it is advisable that one should avoid touching any part of the face within 5 min of hand wash (Goel et al. 2020 ).Other factors of COVID-19 transmission may also be considered as sneezing, coughing, and talking with any infected person. In many studies, presence of COVID-19 virus has been diagnosed in the excreta, tear, urine and other body secretions of the infected people (Zhang et al. 2020 ; Xia et al. 2020 ; Peng et al. 2020 ). In Japan, a study has shown that COVID-19 transmission is also possible through the lighter water droplets containing virus. As lighter water droplets (or aerosols) when come in the contact of any COVID-19 infected person and thereafter it can transmit into healthy people. However, this type of airborne infection depends upon the local weather conditions (wet or dry) (Chin and Poon 2020 ; Wölfel et al. 2020 ). Moreover, a theory of asymptomatic or oligosymptomatic infections are also reported in the literatures (Wölfel et al. 2020 ). There are different types of which can trigger in the transmission of the COVID-19 (Fig. 2 ).

Responsible factors for the human transmission of COVID-19

Most importantly, poor people (may be due to insanitary practices), elderly persons, workers of waste management authorities are in high risk zone of COVID-19 infection. However, their restricted movement can reduce the chance of pandemic outbreak (United Nations 2020 ). Because of this reason, in USA and Singapore, recycling of waste materials has been discontinued or carried out with less frequency to reduce the risk of further transmission of COVID-19 among the sanitary workers (Zambrano-Monserrate et al. 2020 ; National Environmental Agency, Singapore 2020 ). In developing world, situation has become very critical during this pandemic because of unemployment during lockdown and panic of infection among waste management people, and ultimately, it may affect the economy of the nations too (World Bank 2020 ). According to Nghiem et al. ( 2020 ) and Kulkarni and Anantharama ( 2020 ) it can be managed by adopting best practices of waste management to safeguard the health of these workers during handling of contagious wastes. Major objective of the present research paper is to explore the practices which can be helpful in the management of biomedical wastes during pandemic like COVID-19. Moreover, alternatives options and challenges of future have also been discussed.

Impacts of COVID-19 pandemic

(i) impact on the human health.

Human respiration system is the main target of this COVID-19 virus. Moreover, this has become more dangerous for the elderly people or the people who are suffering with sever diseases related with cardiac system, diabetes, cancer, or else (Dhama et al. 2020 ; Rodriguez-Morales et al. 2020 ; Mahajan and Kaushal 2020 ). However, it has also found that children are not a common victim of the COVID-19 virus (Huang et al. 2020 ) because usually they do not go outside the home as well as less travelling exercise (Lee et al. 2020 ). Chen et al. ( 2020 ) reported that only in China health recovery of the citizens was so better due to an improvement in air quality amid COVID-19 lockdown periods. Therefore, due to lockdown, the pollution load of environmental systems (atmosphere, hydrosphere and lithosphere) has decreased worldwide and this may be helpful for the protection of public health. Figure  3 shows the confirmed infections of COVID-19 in top ten countries as on Sept. 30, 2020.

Total COVID-19 infections in top 10 mostly affected countries (WHO 2020b ) (assessed on the 30.09.2020)

From Fig.  3 , it appears that till Sept. 30, most affected countries with COVID-19 infections are USA, Indian, Brazil, Russia and Columbia. Similar problems have been observed in the Bangladesh during lockdown periods amid COVID-19 pandemic (Hopman et al. 2020 ). Transmission of corona virus through air is also reported (Bourouiba 2020 ) and can be prevented by using face mask at crowded places (Klemeš et al. 2020 ). Moreover, during the crisis maintaining employment opportunities along with public health protection has become top priorities of the government authorities. For public health protection, there are many issues should be handles with due care like advancement of medical standards, easy availability of testing facility, revisions of policies for local public etc. (WHO 2020b ; Sharma et al. 2020 ). In addition to these, many psychological disorders have been observed especially among patients due to this pandemic as studied in United Kingdom (Ford et al. 2020 ; Holmes et al. 2020 ). Figure  4 summarises the diverse types of impacts observed during the COVID-19 outbreak.

Impact of COVID-19 on the environment and human beings

Elderly people are found at the larger risks of COVID-19 and during quarantine period, there is a great chance of developing mental disorders (for example, anxiety, guiltiness, dementia, depression etc.) because of loneliness (Armitage and Nellums 2020 ; Holmes et al. 2020 ; Ahorsu et al. 2020 ; Shammi et al. 2020 ).These mental problems may be responsible for the increase in number of suicide cases in the society (Duan and Zhu 2020 ). However, few medicines are recommended in case of emergency situation for COVID-19 patients (Singh et al. 2020 ). Recently, Goel et al. ( 2020 ) reported that silver coated grapheme oxide sheets and chiral gold nanohybrids for the inhibition as well as detection of the different types of viruses including corona virus. According to Chan ( 2020 ) application of different types of nano-materials should also be explored against the coronavirus. Because of unavailability of proper medication, “social lockdown” or “social distancing” has been imposed to stop the transmission of COVID-19 virus across the world (Paital et al. 2020 ; Zambrano-Monserrate et al. 2020 ; Lokhandwala and Gautam 2020 ; Somani et al. 2020 ). During lockdown, restrictions were imposed on every type of public meetings, industries and automobiles to maintain social distancing. Due to shutdown of factories and vehicles many positive changes have been observed in the cosmopolitan environment.

(ii) Impact on the environmental systems

In twenty-first century, there are many challenges for whole world including severe environmental quality diminution (Chakraborty and Maity 2020 ) due to over industrialization as well as unorganized fast urbanization as it requires huge demand of natural resources. Because of overexploitation of resources, ecological systems have been deteriorated which includes air pollution, water quality degradation, soil contamination, global warming, threat to the biodiversity, human health problems etc. (Bremer et al. 2019 ). Amid COVID-19 pandemic, world has gone into complete lockdown except essential commodities which imposed ban on the opening of industries as well as movement of the vehicles. Hence, during lockdown periods emission of harmful gases and wastewater discharges were decreased significantly and considerable environmental healing was observed across the world (Australia, China, France, Germany, India, Italy, Iran, Spain, South Korea, Taiwan, Turkey, United Kingdom and USA) since March 2020 (Chakraborty and Maity 2020 ; Elavarasan and Pugazhendhi 2020 ; Atalan 2020 ). As it has been observed that air pollution is responsible for > 7 million human deaths in whole world and out of it, 1.2 million deaths were reported in only in India (WHO 2018 ; Polk 2019 ). Significant reduction in the concentration of air pollutants (particulate matters and greenhouse gases) was reported from the various parts of the world like Kazakhstan (Kerimray et al. 2020 ), India (Mahato et al. 2020 ) and Brazil (Dantas et al. 2020 ). Besides, industries and automobiles, operations of aeroplanes were also affected during lockdown and it was also helped in the reduction of greenhouse gases in the atmosphere (Corletta et al. 2020 ). However, level of indoor air pollutants (including black carbon of smoke) was increased amid lockdown as most of the people were got stuck inside their homes (NASA 2020 ). Availability of adequate natural ventilation (not any artificial systems like air conditioner etc.) inside the homes could dilute the concentrations of indoor air pollutants (Bhatia and Bhaskar 2020 ; Somani et al. 2020 ). Moreover, concentrations of greenhouse gases were also remarkably decreased during lockdown periods, for example 2600 metric tons of carbon dioxide was decreased across the global amid COVID-19 pandemic (Global Climate Report 2019 ) due to less energy demand as around 64% of total electrical energy is getting produced from the natural gas and coals (Somani et al. 2020 ). In India, the carbon dioxide emission was decreased in between 15 and 30% during March to April, 2020 (Myllavirta and Dahiya 2020 ). Similarly, due to closure of machines and restricted vehicle movements, level of noise also got decreased as reported in many countries such as China (19%), USA (36%) and United Kingdom (54%) (Somani et al. 2020 ). Moreover, decrease in oceanic noise levels were also observed during lockdown due to limited waterways traffic and it could have provided a better environment for aquatic lives (Ian Randall 2020 ). In India, around 40–75% noise level reductions were reported from the various states or cities (for example, Karnataka, Delhi, Bengaluru, Kolkata ) due to non-movements of the trains (Somani et al. 2020 ) as trains and other vehicles are the principal causes of noise pollution in megacities of India (Mishra et al. 2010 ). Furthermore, biodiversity conservation via revival of natural shelters for marine organisms (turtles), other aquatic lives, birds, wild life animals were found to be very rapid due to less movement of human beings (Corletta et al. 2020 ; Zambrano-Monserrate et al. 2020 ) as the reports were published in the countries like Mexico, Spain, India as well as Ecuador (Zambrano-Monserrate et al. 2020 ; Somani et al. 2020 ). Self-purification capacities of many rivers/lakes increased amid lockdown because of less wastewater discharge as most of the pollution in surface water reservoirs is due to the raw sewage mixing into them (Sinha et al. 2016 ; CPCB 2020a ; Corletta et al. 2020 ; Zambrano-Monserrate et al. 2020 ). In India, amid lockdown, water quality of rivers Ganga and Yamuna were improved for bathing and aquaculture purpose as observed by the Central Pollution Control Board (CPCB) than previous years (CPCB 2020a ). Most importantly, Uttarakhand Pollution Control Board of India stated that Ganga river water at Haridwar (location: Har-ki-Pauri) was improved for drinking purpose after more than 30 years (Katariya 2020 ). Similarly, (Yunus et al. 2020 ) reported ~ 15.6% water pollution reduction in the Venbanad Lake of Kerala province of India. These improvements were observed in many Indian states ( Uttrakhand, UttarPradesh, West Bengal, Karnataka, Tamilnadu ) because of very less number of visitors, drastic decrease in the volume of the untreated effluents (~ 500%) during lockdown periods (Somani et al. 2020 ).

Challenges of biomedical waste generation and its proper management amid COVID-19 pandemic

Apart from some environmental benefits, great negative impacts will be observed across the globe due to COVID-19 pandemic including public health crisis (WHO 2020a ) including hurdles in the recycling of the wastes (Calma 2020 ), economical emergency and unemployment (Atalan 2020 ), proper management and disposal of hospital wastes and need of extra disinfectants (Zambrano-Monserrate et al. 2020 ). Certainly, COVID-19 pandemic is one of the greatest challenges for everyone such as the scientists, industrialists, doctors, paramedical staffs, police, municipal authorities, government authorities as well as local public of the world. Since its beginning in 2019 from China, researchers of the world are working 24 h a day to develop effective medication/or vaccine against it. However, no any solution is reported till now against this virus (Vellingiri et al. 2020 ). Because of high mutagenic characters and continuous morphological changes in the COVID-19, development of its vaccine is facing difficulties (American Society of Microbiology 2020 ). Therefore, governments of most of the nations have imposed compulsory national lockdowns to keep safe their citizens except essential supplies of the goods and medicines. Apart from it, individual physical distancing and self-quarantine were also recommended for each person to ensure wellbeing (Balachandar et al. 2020 ). On the other hand, because of the lockdown, worldwide huge economical loss is expected in near future (Somani et al. 2020 ) due to closure of industries and manufacturing units (United Nations Industrial Development Organization 2020 ). Because of shutting industries, product supply chain of goods has been ruined (Kahlert and Bening 2020 ; Kulkarni and Anantharama 2020 ). In addition to huge economical loss, health workers and hospitals of the world (both developed and developing countries) are under tremendous pressure due to exponential rate of COVID-19 infections. Moreover, critical patients are not getting proper care due to unavailability of intensive care units in most of the hospitals. Health workers are using personal protective equipments (for example, face mask, transparent face shield, gloves etc.) to protect themselves from this virus and providing these safety devices are also a challenge for the authorities (Dargaville et al. 2020 ). Some misconceptions have been spread into the society that intake of lemon beverages, wine etc. can be used as medications against Coronavirus (Shammi et al. 2020 ). Moreover, in most of the countries, numbers of unemployed personas have been increased due to the pandemic (Kulkarni and Anantharama 2020 ). In order to handle these challenges, many governments are planning effective strategies for the sustainable development of the world after COVID-19 era (Rosenbloom and Markard 2020 ).

Owing to lockdown amid COVID-19 pandemic, world has gone under environmental reformation in terms of clean rivers and blue skies, whereas, this pandemic has created lots of problems in the management of solid waste (Gardiner 2020 ). Appropriate solid waste management has been a big challenge for the world especially to the developing nations. COVID-19 pandemic has boosted this problem many folds because of unexpected generations of waste materials (especially biomedical waste: a type of hazardous waste). It needs to be given extraordinary attentions by the waste management authorities and governments (Ferronato and Torretta 2019 ; Kaufman and Chasan 2020 ) as the compositions and volumes of the waste materials has been changed (Mallapur 2020 ). Moreover, Fan et al. ( 2021 ) reported that during COVID-19 pandemic many challenges have been emerged while managing waste materials because of changes observed in the volume, types, composition, disposal rate, frequency of collection, availability of treatment options, funds availability etc. as shown in Fig.  5 .

modified from Fan et al. 2021 )

Common challenges of infected waste management during pandemic (

In order to prevent transmission of COVID-19, lockdown was imposed in many countries which increased online shopping for the household products especially in developed countries. This panic situation has created a big concern of proper waste management in terms of collection, recycle, treatment as well as disposal (Zambrano-Monserrate et al. 2020 ; Nghiem et al. 2020 ). Moreover, Rahman et al. ( 2020 ) observed that hospital waste can cause severe environmental as well as public health problems as 5.2 million people of the world are dying annually due to mismanagement of hospital waste materials. During the pandemic, the composition of medical waste has changed drastically as it contains huge quantities of discarded masks, gloves, PPE kits etc. (UNEP 2020 ; Somani et al. 2020 ) and it could be dangerous for the society (especially workers of waste management authorities) in terms of increasing transmission due to mishandling of such types of infected wastes (Sharma et al. 2020 ). Similar, concern was also expressed by Occupational Safety and Health Administration (OSHA) regarding further infections among the workers of waste management authorities (OSHA 2020 ). Further, wastage of plastic waste also got increased across the world which is being used by pharmaceutical industries for packaging purpose (WHO 2020d ). Therefore, World Health Organization, Central Pollution Control Board (India), OSHA and other prestigious international organizations have developed new guidelines to manage the waste materials (especially hospital wastes) during COVID-19 (Somani et al. 2020 ; Kulkarni and Anantharama 2020 ). According to WHO, > 80% wastes of the hospitals were found in the category of noncontiguous wastes which can be treated and managed similar as municipal waste materials (WHO 2020d ). Normally, biomedical wastes are waste generated from the hospitals and veterinary medical premises including syringe, pathological materials, pharmaceutics etc. (Sharma et al. 2020 ; Somani et al. 2020 ). Due to COVID-19 pandemic, huge mass of plastic wastes has been increased across the world as it is being used in personal protection kits (for example, gloves, masks, face shield, ventilator etc.) (Klemeš et al. 2020 ). In India, waste management authorities are in more trouble due to fear of infection as safety measures are not good in the comparison of developed countries. During, lockdown in India, the bulk of biomedical waste was found to be greater than the municipal solid wastes (Somani et al. 2020 ). Significant reduction in municipal solid waste quantity was attributed to the shutdown of markets, shops, hotels, commercial premises, offices, transport etc. (Somani et al. 2020 ), whereas, huge amount of biomedical waste was generated probably because of high numbers of the COVID-19 infected persons admitted in the hospitals. In USA, huge quantities of food waste were generated during lockdown as most of the commercial institutes (like hotels, restaurants, mess etc.) had already purchased the raw materials (Kulkarni and Anantharama 2020 ). During lockdown, similar observations of change in the quantity and composition of waste materials have been reported from North America (SWANA 2020 ) and China (Klemeš et al. 2020 ). According to Klemeš et al. ( 2020 ), only in Hubei (China), around 370% increase in biomedical waste after COVID-19 infections. However, the quantity of municipal solid waste was generated less than 30% during pandemic. Nghiem et al. ( 2020 ) and Zambrano-Monserrate et al. ( 2020 ) have also studied the change in the waste composition (and quantity) along with their negative impacts of change in waste generation on the environment and health workers. They found that transmission of virus in community has significantly affected waste recycling facilities around the world. For instance, in United Kingdom, 46% material recovery process was stopped due to lockdown amid COVID-19 pandemic and similarly 31% recycling units of USA were also closed in the similar situations (Somani et al. 2020 ).

Contagious biomedical wastes can spread disease in living organisms and their mishandling may also be responsible for soil contamination, water pollution (both groundwater and surface water), injuries and death of ecofriendly microbes (Datta et al. 2018 ). Incineration is one of the preferred options for the waste management especially biomedical (or infectious) wastes in developed countries as shown in Fig.  6 .

Proportion of incineration for energy recovery in developed countries before COVID-19 pandemic

From the above figure, it is visible that Japan used to treat municipal solid waste through 74% incineration, 17% recycling and only 3% as landfill disposal before the pandemic (Mollica and Balestieri 2020 ). In Wuhan (China), normally 40 tons of biomedical waste was generated every day and after COVID-19 infections, it was reached up to 240 tons/day. Therefore, the increase in infectious wastes was around 6 times more as compared to normal days. This huge bulk of medical waste created big challenge to the management authorities as Wuhan administration could incinerate only 49 tons (maximum) of waste every day. Moreover, this will not be economical for any country as the costs of incineration for hazardous and municipal solid wastes in China were calculated as 281.7–422.6 USD/tons and 14.1 USD/tons, respectively (Tang 2020 ; Klemeš et al. 2020 ). According to WHO ( 2017 ), usually, 85% biomedical wastes are not hazardous in nature, rest 10% may be infectious along with 5% radioactive wastes. Before pandemic, except USA (12.7% only) (United States Environmental Protection Agency 2017 ), many developed countries incinerate their waste materials to recover energy such as 50% municipal waste incinerated in Denmark, Finland, Norway and Sweden (Istrate et al. 2020 ); 40% in Austria (Kyriakis et al. 2019 ); 76% in United Kingdom (DEFRA Government of UK 2020 ). However, recycling of the waste reported 32% in Austria (including composting) (Kyriakis et al. 2019 ); 45% in United Kingdom (DEFRA Government of UK 2020 ), and 35.2% in USA (both recycling and composting) (United States Environmental Protection Agency 2017 ). Therefore, it can be seen from the above results that collection and recycling of waste materials has been disturbed due COVID-19 pandemic. Moreover, pandemic has caused huge economical losses by many ways to the affected countries along with an unseen fear of its infections. Datta et al. ( 2018 ) studied that in India by the year 2017, 500 MT/day biomedical wastes were generated and infrastructure of managing biomedical waste is not good. Hence, based on the data of biomedical waste generated in Wuhan (> 6 times) during pandemic, India this situation is expected. However, till now biomedical waste generation data is not available for whole India (Somani et al. 2020 ). Further, according to one Indian leading newspaper in Gurugram (India), only in 2 months of pandemic, the quantity of biomedical wastes has increased around 40 times as compared to normal months. Similarly, before pandemic 550–600 kg biomedical waste was generated every day in Ahmadabad. Now, it has already increased up to 1000 kg/day during pandemic with an expectation of reaching up to 3000 kg/day especially in the red zones (COVID-19 containment zones (TOI 2020 ; Somani et al. 2020 ). Tables 1 and 2 shows the biomedical waste generation in some Asian cities and Indian cities/states.

From Table 1 , it can be seen that around every Asian city, the quantity of biomedical wastes has been increased many folds during the outbreak of COVID-19 in the community. In terms of maximum additional biomedical waste was generated in the capital of Philippines, i.e., Manila followed by Jakarta (Indonesia). In, Wuhan (China) and Bangkok (Thailand), 210 tons of additional biomedical waste was generated amid COVID-19 pandemic (ADB 2020 ). Improper medical waste handling may increase the number of COVID-19 infections in the community (Peng et al. 2020 ) due to presence of pathogenic microbes (Windfeld and Brooks 2015 ). Due to airborne infections of the COVID-19 virus in healthy people, use of masks, gloves, face cover etc. has been also increased up to dangerous levels in the world (Bourouiba 2020 ). At global level, 89 million masks and 76 million gloves are required against the protection from COVID-19 infection (WHO 2020c ). According to UNEP ( 2020 ), appropriate management of extra waste materials generated during COVID-19 pandemic has become a major concern for the countries. Therefore, medical wastes from the COVID-19 affected zones/hospitals need to be disinfected with careful handling. Treatment of medical waste can be carried out by using thermal techniques such as autoclaving, incineration, microwave and plasma method. However, selection above processes of waste treatment will be governed by many factors like economic feasibility, easy and safe handling, eco-friendly nature as well as harmless to the society (Liu et al. 2015 ). In order to reduce the chance of infection in the community, effective medical waste (or infectious waste) management should be adapted. Apart from collection and transport, trained manpower should be involved in this activity and disinfection of infectious waste should be compulsory (Klemeš et al. 2020 ).

The waste management as well as waste recycling process of the developed nations has been disturbed due to this COVID-19 outbreak. Figure  7 shows the waste management practices adapted by developed countries.

Management practices for solid wastes in some developed countries (ACRPlus 2020 ; Nghiem et al. 2020 ; Kulkarni and Anantharama 2020 ). (Reprinted from Kulkarni and Anantharama 2020 with permission from Elsevier)

From Fig.  7 , it can be seen that in developed countries waste management practice involves segregation of the waste at the source of generation followed by their effective collection, transpiration, treatment and disposal. However, during COVID-19 outbreak, the waste collection guidelines were changed as segregation and collection of the wastes from the infected area is carried out after a waiting period of 72 h (ACRPlus 2020 ; Nghiem et al. 2020 ). In most of the Asian countries like Bangladesh, India, Indonesia, Malaysia, Myanmar and Thailand, municipal solid wastes are getting managed by land-filling (Yadav and Samadder 2018 ). Integrated solid waste management system can be a good alternative for the recycling of wastes and also producing energy from the waste materials (Ramachandra et al. 2018 ). Lack of scientific designing of land-fill sites for waste disposal may lead several environmental problems such as air pollution, water pollution, soil pollution, marine pollution and vector borne-diseases among humans (Pujara et al. 2019 ). Therefore, mishandling of the biomedical wastes will be more dangerous as it may cause infections in the living organisms.

Biomedical waste management is a big challenge for every country especially during this pandemic time. According to the WHO, most of the developing countries do not have advanced systems for the management of biomedical wastes (Chartier et al. 2014 ). Chartier et al. ( 2014 ) proposed a close pit (as shown in Fig.  8 a) which should have a dimension of 2 m and 3 m and can be made by clay or geo-synthetic materials used at the base. This arrangement can be used for the safe management of biomedical wastes in emergency situations such as COVId-19 pandemic.

a Layout of a pit for onsite disposal of biomedical wastes in low-income countries during COVID-19 like emergency situation (Chartier et al. 2014 ; Sharma et al. 2020 ). (Reprinted from Sharma et al. 2020 with permission from Elsevier). b COVID-19 infected waste handling procedure for low income countries

Figure  8 a gives a temporary arrangement for the effective and safe disposal of biomedical wastes in low-income countries (Chartier et al. 2014 ; Sharma et al. 2020 ). Further, Fig.  8 b can be adopted during the handling infected hospital wastes.

Figure  8 b gives a detail outline for the management of infected wastes generated during the pandemic like COVID-19. In this diagram, it can be seen that disinfection of hospital waste has become very important as recommended by many government authorities of the world. For disinfection, autoclaving and sterilization of the tools can be carried out at the temperature ranged between 121 and 149 °C or with the spraying of 0.1% of NaClO. After, disinfection processes, the medical wastes can be shredded and incinerated (~ 1000 °C temperature) followed by ultimate disposal in landfills. Further, incineration has been considered as the best method for the treatment of hazardous wastes (e.g. medical wastes) as it will condense the weight along with volume of the wastes (Rajor et al. 2012 ). Even, US Environmental Protection Agency (USEPA 2020 ) issued special guidelines for managing food wastes of residential colonies and other commercial buildings during pandemic. Similarly, Government of India issued guidelines for the management of waste products generated during sudden lockdown. These wastes included perishable agricultural products as well (FAO 2020 ). According to Klemeš et al. ( 2020 ), environment and human health can be protected well after appropriate waste management. Hospital or infectious wastes can be managed effectively through proper collection, transport, treatment and final disposal. It also requires trained health workers who should be aware about the proper disinfection process along with self-protection too. Wasted PPE kits volume can also be decreased, if these materials (like antiviral masks, face shields etc.) can be reused after disinfections (Goel et al. 2020 ).Previously, viral disinfection was achieved by using UV-C rays (at 254 nm) in 40 min (Darnell et al. 2004 ), but in case of COVID-19, it is a matter of exploration. Moreover, it was also reported that UV-C rays can lead skin and eye disorders. Therefore, it must be examined before suggesting the application of UV-C rays as a disinfectant (Goel et al. 2020 ).Thermal treatment of waste can be an alternative for their management as it will generate energy along with reducing waste volume by 80–95%, and mineralization etc. (Singh et al. 2011 ; Brunner and Rechberger 2015 ; World Bank 2018 ). Implementation of these technologies were successful in some developed and developing countries and land-filling has become a rare practice in the developed nations because of land scarcity or/and environmental pollutions. Further, due to high investments, in developing countries it is still inaccessible (Mayer et al. 2019 ). Apart from the above advantages, incineration generates the ash residues which may contain toxic metals etc. Similarly, groundwater contamination may happen due to the disposal of such residues in the landfills (Rajor et al. 2012 ). Dargaville et al. ( 2020 ) recommended some steps to reduce the wastage of PPE kits which includes:

To explore the possibility of recycling of PPE kits (gloves, mask, face shield etc.);

Disinfection should be ensured before recycling

One of the best disinfection methods should be shared with everyone (especially medical workers)

Material’s properties should be examined before recycling

Fix the guidelines for their number of recycling

Exchange of recycled materials should not be allowed

Time to time expert’s (material science, clinical doctors, virologist etc.) guidelines should be shared.

These are the general guidelines to be followed everywhere to reduce the quantity of medical wastes along with the human health and environmental protections (Dargaville et al. 2020 ).According to WHO, thermal treatment and/or application of conventional biocidal materials can be integrated with waste treatment systems for inactivating Coronavirus before the disposal of biomedical wastes (Kampf et al. 2020 ). Apart from these options of biomedical waste management; some extra efforts are needed to upgrade the existing waste management systems so that it can deal with emergency situations like this pandemic (COVID-19).

Some challenges observed as wastes are also generated from the mildly infected or asymptomatic people that may have viral infections. COVID-19 virus can be present in active form for different time periods (few hours to days) on the cardboards, plastic materials and metallic objects (Kampf et al. 2020 ; Doremalen et al. 2020 ; Nghiem et al. 2020 ). Somani et al. ( 2020 ) observed other waste materials which may be considered as infectious in nature, if not treated properly. These wastes are syringe, needles, masks, gloves, medicines, discarded materials from the home quarantine patients etc. Mishandling of these wastes may trigger the chance of more infections in public as well as health workers (Sharma et al. 2020 ; Kulkarni and Anantharama 2020 ).Further studies have shown that in between 21 and 23 °C temperature in presence of 40% relative humidity, the survival time of Coronavirus was 7 days. However, in atmosphere, with 65% relative humidity the activation time was drastically reduced up to 3 h with same temperature range (Doremalen et al. 2020 ). Kampf et al. ( 2020 ) reported 9 days active period of Coronavirus on the metal, glass or plastic. Further, Chin et al. ( 2020 ) found that at 70 °C, COVID-19 virus did not survive more than 5 min. National Biodefense Analysis and Countermeasures Centre, USA found in the initial studies that direct sunlight can be very effective to inactivate the Coronavirus within minutes from the many surfaces (Goel et al. 2020 ). Better management of the wastes can be carried out by optimizing the decision process, infrastructure, upgrading treatment methods and other activities related with the biological disasters like COVID-19 (Klemeš et al. 2020 ).

Provisions for biomedical waste management in India amid COVID-19

According to Bio-Medical Waste Management Rules, 2016 passed by Indian parliament data of biomedical waste generation should be updated on daily basis by the health care service providers and also, they must expose monthly information on their website (BMWM 2016 ). These rules were amended at time to time as per the need of the hour to make the effective biomedical waste management in the country. Amid COVID-19 pandemic, like other countries, Indian government has also taken many initiations for the purpose of quarantine, isolation, sampling, laboratory works etc. These initiatives were in agreement with the guidelines of various international (WHO, CDC etc.) and national agencies (MoH&FW, ICMR, CPCB etc.) such as application of separate colour storage basket or double layered bags with proper labelling, separate collection for biomedical wastes etc. During COVID-19 pandemic, some activities were recommended for the rapid and effective waste management by the Indian government to reduce the chance of further infections such as use PPE kits especially by the health workers/waste management people, providing training for their safety, record maintenance, extra working times for treatment facilities etc. (Soni 2020 ). CPCB has developed a mobile app, i.e., ‘COVID19BWM’ for the daily updation of the generation of biomedical wastes from COVID-19 related places. Moreover, 0.5% chlorine solution was recommended for the disinfection purpose where the patients wards. However, COVID-19 waste and their storage places should be disinfected with 1% sodium hypochlorite solution on daily basis (CPCB 2020b ). These guidelines were revised again (on July 17, 2020) and some significant amendments were carried out to fight with the COVID-19 virus such as rail coaches can also be used as isolation wards the materials used by COVID-19 patients included in the category of biomedical waste and their treatment should be mandatory as per the guidelines provided by CPCB and yellow bags can be used for their collection. It was mandatory that do not mix the municipal solid wastes with the waste generated from the COVID-19 infected places/homes (CPCB 2020c ). There, it can be said that despite of being a developing nation, Indian authorities are also doing lots of efforts to reduce the numbers of COVID-19 infections in the community.

Amid COVID-19, world has gone under environmental reformation in terms of clean rivers and blue skies, whereas, this pandemic has hurdled the appropriate solid waste management process and the same has emerged as a big threat for the world especially to the developing nations. Researchers have suggested some steps to reduce the wastage of biomedical waste and explored the mechanisms of safe and hygienic recycling. As advised by the WHO, developing countries, who are deficient of advanced systems for the management of biomedical wastes should follow the temporary solution of a close pit with a dimension of 2 m and 3 m and can be made by clay or geo-synthetic materials used at the base and the same arrangement can be used for the safe management of biomedical wastes in emergency situations such as COVId-19 pandemic wastes in emergency situations. The paper summarizes that better management of the wastes can be carried out by optimizing the decision process, infrastructure, upgrading treatment methods and other activities related with the biological disasters like COVID-19. National Biodefense Analysis and Countermeasures Centre, USA found in the initial studies that direct sunlight can be very effective to inactivate the Coronavirus within minutes from the many surfaces. Hospital or infectious wastes can be managed effectively through proper collection, transport, treatment and final disposal. The health workers must be trained enough and should be aware about the proper disinfection process along with self-protection too. Wasted PPE kits volume can also be decreased by reusing the same after disinfections. As achieved in the past for viral disinfection, the use of UV-C rays with proper precautions can also be explored for COVID-19 disinfection. Waste management especially for biomedical waste management, thermal treatment of waste can be an alternative, as it can generate energy along with reducing waste volume by 80–95%.

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Kanwar, V.S., Sharma, A., Rinku et al. An overview for biomedical waste management during pandemic like COVID-19. Int. J. Environ. Sci. Technol. 20 , 8025–8040 (2023). https://doi.org/10.1007/s13762-022-04287-5

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Biomedical Waste Management and Its Importance: A Systematic Review

Himani s bansod.

1 Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND

Prasad Deshmukh

2 Head and Neck Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND

The waste generated in various hospitals and healthcare facilities, including the waste of industries, can be grouped under biomedical waste (BMW). The constituents of this type of waste are various infectious and hazardous materials. This waste is then identified, segregated, and treated scientifically. There is an inevitable need for healthcare professionals to have adequate knowledge and a proper attitude towards BMW and its management. BMW generated can either be solid or liquid waste comprising infectious or potentially infectious materials, such as medical, research, or laboratory waste. There is a high possibility that inappropriate management of BMW can cause infections to healthcare workers, the patients visiting the facilities, and the surrounding environment and community. BMW can also be classified into general, pathological, radioactive, chemical, infectious, sharps, pharmaceuticals, or pressurized wastes. India has well-established rules for the proper handling and management of BMW. Biomedical Waste Management Rules, 2016 (BMWM Rules, 2016) specify that every healthcare facility shall take all necessary steps to ensure that BMW is handled without any adverse effect on human and environmental health. This document contains six schedules, including the category of BMW, the color coding and type of containers, and labels for BMW containers or bags, which should be non-washable and visible. A label for the transportation of BMW containers, the standard for treatment and disposal, and the schedule for waste treatment facilities such as incinerators and autoclaves are included in the schedule. The new rules established in India are meant to improve the segregation, transportation, disposal methods, and treatment of BMW. This proper management is intended to decrease environmental pollution because, if not managed properly, BMW can cause air, water, and land pollution. Collective teamwork with committed government support in finance and infrastructure development is a very important requirement for the effective disposal of BMW. Devoted healthcare workers and facilities are also significant. Further, the proper and continuous monitoring of BMW is a vital necessity. Therefore, developing environmentally friendly methods and the right plan and protocols for the disposal of BMW is very important to achieve a goal of a green and clean environment. The aim of this review article is to provide systematic evidence-based information along with a comprehensive study of BMW in an organized manner.

Introduction and background

The amount of daily biomedical waste (BMW) produced in India is enormous [ 1 ]. People from all segments of society, regardless of age, sex, ethnicity, or religion, visit hospitals, which results in the production of BMW, which is becoming increasingly copious and heterogeneous [ 2 ]. BMW produced in India is about 1.5-2 kg/bed/day [ 3 ]. BMW include anatomical waste, sharps, laboratory waste, and others and, if not carefully segregated, can be fatal. Additionally, inappropriate segregation of dirty plastic, a cytotoxic and recyclable material, might harm our ecosystem [ 4 ]. Earlier, BMW was not considered a threat to humans and the environment. In the 1980s and 1990s, fears about contact with infectious microorganisms such as human immunodeficiency virus (HIV) and hepatitis B virus (HBV) prompted people to consider the potential risks of BMW [ 5 ]. BMW is hazardous in nature as it consists of potential viruses or other disease-causing microbial particles; it may be present in human samples, blood bags, needles, cotton swabs, dressing material, beddings, and others. Therefore, the mismanagement of BMW is a community health problem. The general public must also take specific actions to mitigate the rising environmental degradation brought on by negligent BMW management. On July 20, 1998, BMW (Management and Handling) Rules were framed. On March 28, 2016, under the Environment (Protection) Act, 1986, the Ministry of Environment and Forest (MoEF) implemented the new BMW Rules (2016) and replaced the earlier one (1988). BMW produced goes through a new protocol or approach that helps in its appropriate management in terms of its characterization, quantification, segregation, storage, transport, and treatment.

According to Chapter 2 of the Medical Waste Management and Processing Rules, 2016, “The BMW could not be mixed with other wastes at any stage while producing inside hospitals, while collecting from hospitals, while transporting, and should be processed separately based on classification.” The COVID-19 pandemic has now transformed healthy societies worldwide into diseased ones, resulting in a very high number of deaths. It also created one significant problem: improper handling of the medical waste produced in the testing and treatment of the disease [ 6 ]. In India, BMW generated due to COVID-19 contributed to about 126 tonnes per day out of the 710 tonnes of waste produced daily [ 7 ]. 

The basic principle of the management of BMW is Reduce, Reuse, and Recycle-the 3Rs. Out of the total amount of BMW generated, 85% is general (non-hazardous) waste, and the remaining 15% is hazardous. As BMW contains sharps and syringes, the pathogens can enter the human body through cuts, abrasions, puncture wounds, and other ways. There might also be chances of ingestion and inhalation of BMW, which can lead to infections. Some examples of infections are Salmonella, Shigella, Mycobacterium tuberculosis, Streptococcus pneumonia, acquired immunodeficiency syndrome (AIDS), hepatitis A, B, and C, and helminthic infections [ 8 ]. This systematic review is conducted to obtain essential, up-to-date information on BMW for the practical application of its management. The highlight of the management of BMW is that the “success of BMW management depends on segregation at the point of generation” [ 9 ].

The findings have been reported following the principles and criteria of the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA). The systematic review has been conducted according to these standards and principles.

Search Sources/Search Strategy

We used the MeSH strategy to obtain articles from PubMed and ResearchGate employing the following terms: (“Biomedical/waste” [Majr] OR “Biomedical Waste/source” [Majr] OR “Biomedical Waste/hazards” [Majr] OR “Biomedical Waste/segregation” [Majr] OR “Biomedical Waste/rules” [Majr] OR “Biomedical Waste/laws” [Majr] OR “Biomedical Waste/environment” [Majr]). Specifically, for management-related studies, the search terms (“Management/steps” [Majr] OR “Management/handling” [Majr] OR “Management/coding” [Majr] OR “Color coding/segregation” [Majr] OR “Treatment/method” [Majr] OR “Autoclaving/waste” [Majr] OR “Incineration/waste” [Majr]) were used. We obtained the most pertinent research papers and used them in different arrangements using the Boolean operators “AND” and “OR.”

Inclusion and exclusion criteria

We focused on papers written in the English language, published within the last decade, relevant to the central questions of this review article, and that are systematic reviews such as randomized clinical trials and observational studies. We, however, excluded papers published in languages other than English, irrelevant to the questions, and related to topics other than BMW.

Search outcomes

After the initial screening, we narrowed the search results down to 264 papers. A total of 42 duplicate papers were removed. Subsequently, publications were refined by the title/abstract, and we eliminated a few studies due to the lack of full text and/or related articles. Finally, after assessing 27 items for eligibility, we included 11 papers in our review. Figure ​ Figure1 1 is the flow chart for article selection formulated on PRISMA.

PRISMA: Preferred Reporting Items for Systematic Review and Meta-analysis, PMC: PubMed Central

Need for BMW management in hospitals

BMW threatens the health of medical staff, hospital-visiting patients, and people in the nearby community. Improper disposal leads to severe hospital-acquired diseases along with an increased risk of air and water pollution. Due to open-space waste disposal practices, animals and scavengers might get infected, leading to the scattering of waste and the spreading of infections. In countering such activities, four major principle functions of BMW management are applicable: the placement of bins at the source of generation of BMW, segregation of BMW, removal or mutilation of the recyclable waste, and disinfection of the waste [ 10 ]. BMW management methods aim predominantly to avoid the generation of waste and, if generated, then recover as much as possible [ 11 ].

BMW management rules in India

On March 28, 2016, under the Environment (Protection) Act, 1986, the MoEF notified the new BMW Rules, 2016 and replaced the earlier Rules (1988). BMW produced goes through a new protocol or approach which helps in the appropriate management of waste, i.e., its characterization, quantification, segregation, storage, transport, and treatment, all of which aim to decrease environmental pollution [ 12 ]. Problems with the improper management of BMW also shed light on the scavengers who, for recycling, segregate the potentially hazardous BMW without using gloves or masks. Strict rules have been implemented to ensure that there is no stealing of recyclable materials or spillage by some humans or animals and that it is transported to the common BMW treatment facility [ 10 ]. The first solution to stop the spread of hazardous and toxic waste was incineration. Incineration is required in all hospitals and healthcare facilities that produce BMW. However, due to the absence of services that provide certified incinerators in a few countries, BMW has to be sent to landfills, which leads to land contamination and harms the environment [ 13 ]. Incinerators used for disposal might also lead to environmental pollution. Numerous toxins are formed during incineration, which are the products of incomplete combustion. Thus, some new standards have been issued to resolve this problem and safeguard the environment and public health [ 14 ].

Steps in the management of BMW

BMW management needs to be organized, as even a single mistake can cause harm to the people in charge. There are six steps in the management of BMW [ 15 ]: surveying the waste produced; segregating, collecting, and categorizing the waste; storing, transporting, and treating the waste. Segregation is the separation of different types of waste generated, which helps reduce the risks resulting from the improper management of BMW. When the waste is simply disposed of, there is an increased risk of the mixture of waste such as sharps with general waste. These sharps can be infectious to the handler of the waste. Further, if not segregated properly, there is a huge chance of syringes and needles disposed of in the hospitals being reused. Segregation prevents this and helps in achieving the goal of recycling the plastic and metal waste generated [ 16 ]. According to Schedule 2, waste must be segregated into containers at the source of its generation, and according to Schedule 3, the container used must be labeled. The schedules of BMW (Management and Handling) Rules, 1998, which were initially ten in number, have now been reduced to four [ 17 ]. The collection of BMW involves the use of different colors of bins for waste disposal. The color is an important indicator for the segregation and identification of different categories of waste into suitable-colored containers. They must be labeled properly based on the place they have been generated, such as hospital wards, rooms, and operation theatres. It is also very important to remember that the waste must be stored for less than 8-10 hours in hospitals with around 250 beds and 24 hours in nursing homes. The storage bag or area must be marked with a sign [ 16 ]. 

Figure ​ Figure1 1 shows the biohazard signs that symbolize the nature of waste to the general public.

Biohazards are substances that threaten all living things on earth. The biohazard symbol presented in Figure ​ Figure1 1 was remarked as an important public sign, signaling the harms and hazards of entering the specified zone or room [ 18 ]. Along with the biohazard sign, the room door must have a label saying “AUTHORISED PERSONNEL ONLY.” The temporary storage room must always be locked and away from the general public's reach. The waste is then collected by the vehicles daily. A ramp must be present for easy transportation. The waste collected is then taken for treatment. The loading of wastes should not be done manually. It is very vital to properly close or tie the bag or the container to avoid any spillage and harm to the handlers, the public, and the environment. The transport vehicle or trolley must be properly covered, and the route used must be the one with less traffic flow [ 19 ].

BMW handling staff should be provided with personal protective equipment (PPE), gloves, masks, and boots. BMW retrievers must be provided with rubber gloves that should be bright yellow. After usage, the importance of disinfecting or washing the gloves twice should be highlighted. The staff working in or near the incinerator chamber must be provided with a non-inflammable kit. This kit consists of a gas mask that should cover the nose and mouth of the staff member. The boots should cover the leg up to the ankle to protect from splashes and must be anti-skid [ 16 ]. According to the revised BMW management rules, 2016, it is mandatory to provide proper training to healthcare facility staff members on handling BMW. The training should be mandatorily conducted annually. Along with the management step of the color coding for segregation, it is also important for the staff to be trained in record keeping. This practice of record-keeping helps track the total amount of waste generated and the problems that occurred during the management process, thus helping improve segregation, treatment, and disposal [ 20 ].

Color coding for segregation of BMW

Color coding is the first step of BMW management. Different wastes are classified into different types, and therefore, they must be handled and disposed of according to their classification. The bins used for waste disposal in all healthcare facilities worldwide are always color-coded. Based on the rule of universality, bins are assigned a specific color, according to which the waste is segregated. This step helps avoid the chaos that occurs when all types of waste are jumbled, which can lead to improper handling and disposal and further result in the contraction of several diseases [ 21 ]. The different kinds of categories of waste include sharp waste such as scalpels, blades, needles, and objects that can cause a puncture wound, anatomical waste, recyclable contaminated waste, chemicals, laboratory waste such as specimens, blood bags, vaccines, and medicines that are discarded. All the above-mentioned wastes are segregated in different colored bins and sent for treatment [ 22 ]. Yellow bins collect anatomical waste, infectious waste, chemical waste, laboratory waste, and pharmaceutical waste, covering almost all types of BMW. Different bins and various types of sterilization methods are used depending on how hazardous the waste is. The best tools for sterilization are autoclaves. Red bins collect recyclable contaminated wastes, and non-chlorinated plastic bags are used for BMW collection. Blue containers collect hospital glassware waste such as vials and ampoules. White bins are translucent where discarded and contaminated sharps are disposed of. Sharp wastes must always be disposed of in puncture-proof containers to avoid accidents leading to handlers contracting diseases [ 23 , 24 ]. 

Figure ​ Figure3 3 illustrates the different colored bins used for the segregation of BMW.

BMW management refers to completely removing all the hazardous and infectious waste generated from hospital settings. The importance of waste treatment is to remove all the pathogenic organisms by decontaminating the waste generated. This helps in the prevention of many severe health-related issues that can be caused because of the infective waste. It is a method used to prevent all environmental hazards [ 25 ].

Methods for the treatment of BMW

There are many methods that are used for the treatment of BMW. One of the most economical ways of waste treatment is incineration, which is just not some simple “burning” but the burning of waste at very high temperatures ranging from 1800℉ to 2000℉ to decrease the total mass of decontaminated waste by converting it into ash and gases, which is then further disposed of in landfills [ 25 , 26 ]. Important instructions associated with the use of incinerators are as follows: chlorinated plastic bags must not be put inside the incinerators as they can produce dioxin [ 26 ]. Metals should not be destroyed in an incinerator. The metals present in BMW are made of polyvinyl chloride. When these metals are burned, they produce a huge amount of dioxin. Dioxins are very toxic chlorinated chemical compounds, as dioxins, when released into the environment, can lead to environmental pollution and a higher incidence of cancer and respiratory manifestations [ 14 ].

Autoclaving is an alternate method of incineration. The mechanism of this process involved sterilization using steam and moisture. Operating temperatures and time of autoclaving is 121℃ for 20-30 minutes. The steam destroys pathogenic agents present in the waste and also sterilizes the equipment used in the healthcare facility [ 25 ]. Autoclaving has no health impacts and is very cost-friendly. It is recommended for the treatment of disposables and sharps, but the anatomical, radioactive, and chemical wastes must not be treated in an autoclave [ 27 ]. Chemical methods are the commonest methods that include chemicals such as chlorine, hydrogen peroxide, and Fenton’s reagent. They are used to kill the microorganisms present in the waste and are mainly used for liquid waste, such as blood, urine, and stool. They can also be used to treat solid waste and disinfect the equipment used in hospital settings and surfaces such as floors and walls [ 28 ]. Thermal inactivation is a method that uses high temperatures to kill the microorganisms present in the waste and reduce the waste generated in larger volumes. The temperature differs according to the type of pathogen present in the waste. After the treatment is done, the contents are then discarded into sewers [ 29 ].

Very serious environmental and health hazards can be triggered if hospital waste is mixed with normal garbage, which can lead to poor health and incurable diseases such as AIDS [ 30 ]. The needle sticks can be highly infectious if discarded inappropriately. Injury by these contaminated needles can lead to a high risk of active infection of HBV or HIV [ 31 ]. The groups at increased risk of getting infected accidentally are the medical waste handlers and scavengers. Sharps must properly be disposed of in a translucent thin-walled white bin. If sharps are discarded in a thin plastic bag, there is a high chance that the sharps might puncture the bag and injure the waste handler [ 32 ]. It can also be the main cause of severe air, water, and land pollution. Air pollutants in BMW can remain in the air as spores. These are known as biological air pollutants. Chemical air pollutants are released because of incinerators and open burning. Another type of threat is water pollutants. BMW containing heavy metals when disposed of in water bodies results in severe water contamination. The landfills where the disposal takes place must be constructed properly, or the waste inside might contaminate the nearby water bodies, thus contaminating the drinking water. Land pollution is caused due to open dumping [ 33 ]. BMW must also be kept away from the reach of rodents such as black rats and house mice, which can spread the pathogens to the people living nearby [ 34 ].

Many promising steps were taken to minimize the volume of waste discarded from the source, its treatment, and disposal. The 3R system encourages the waste generators to reuse, reduce, and recycle. Everyone must be aware of the 3Rs because this approach can help achieve a better and cleaner environment [ 35 ]. Unfortunately, most economically developing countries cannot correctly manage BMW. Very few staff members of healthcare facilities are educated about proper waste management. The waste handlers are also poorly educated about the hazards of waste [ 36 ]. Every member helping in the waste management process must be made aware of the dangers of BMW to avoid accidents that harm the environment and living beings [ 37 ].

Conclusions

BMW is generated by healthcare facilities and can be hazardous and infectious. Improper handling can lead to health hazards. Collection, segregation, transportation, treatment, and disposal of BMW are important steps in its management. The color coding of bins, the use of technologies such as incineration and autoclaving, and attention to environmental impacts are also highly crucial. BMW management aims to reduce waste volume and ensure proper disposal. All those involved should strive to make the environment safer.

The content published in Cureus is the result of clinical experience and/or research by independent individuals or organizations. Cureus is not responsible for the scientific accuracy or reliability of data or conclusions published herein. All content published within Cureus is intended only for educational, research and reference purposes. Additionally, articles published within Cureus should not be deemed a suitable substitute for the advice of a qualified health care professional. Do not disregard or avoid professional medical advice due to content published within Cureus.

The authors have declared that no competing interests exist.

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Consortium identifies 5 grand challenges in biomedical engineering

A consortium of 50 renowned researchers from universities around the world, including Cornell Engineering, has published a paper establishing five grand challenges in biomedical engineering, which it said will lay the foundation for a concerted worldwide effort to achieve technological and medical breakthroughs.

The paper titled, “ Grand Challenges at the Interface of Engineering and Medicine ” published Feb. 21 in the IEEE Open Journal of Engineering in Medicine and Biology, and was the result of a two-day workshop organized by the IEEE Engineering in Medicine and Biology Society, the Department of Biomedical Engineering at Johns Hopkins University and the Department of Bioengineering at the University of California San Diego. Among the co-authors is Marjolein van der Meulen, the James M. and Marsha McCormick Director of the Meinig School of Biomedical Engineering at Cornell.

“The interface of engineering and medicine is important and growing, extending beyond biomedical engineering,” said van der Meulen, who is also a senior scientist in the Research Division of the Hospital for Special Surgery. “This workshop brought together leaders in the field to focus on critical areas for future progress, leading to the identification of five grand challenges. These challenges are an opportunity for engineering approaches and interdisciplinary teams to transform human health and disease.”

"What we’ve accomplished here will serve as a roadmap for groundbreaking research to transform the landscape of medicine in the coming decade,” said Dr. Michael Miller, senior author of the paper and professor and director of the Department of Biomedical Engineering at Johns Hopkins University. “The outcomes of the task force, featuring significant research and training opportunities, are poised to resonate in engineering and medicine for decades to come.”

Through the course of the workshop, the researchers identified five primary medical challenges that have yet to be addressed, but, by solving them with advanced biomedical engineering approaches, can greatly improve human health. By focusing on these five areas, the consortium has laid out a roadmap for future research and funding.

The five grand challenges facing biomedical engineering:

1. Bridging precision engineering and precision medicine for personalized physiology avatars In an increasingly digital age, we have technologies that gather immense amounts of data on patients, which clinicians can add to or pull from. Making use of this data to develop accurate models of physiology, called “avatars” – which take into account multimodal measurements and comorbidities, concomitant medications, potential risks and costs – can bridge individual patient data to hyper-personalized care, diagnosis, risk prediction, and treatment. Advanced technologies, such as wearable sensors and digital twins, can provide the basis of a solution to this challenge.

2. The pursuit of on-demand tissue and organ engineering for human health Tissue engineering is entering a pivotal period in which developing tissues and organs on demand, either as permanent or temporary implants, is becoming a reality. To shepherd the growth of this modality, key advancements in stem cell engineering and manufacturing – along with ancillary technologies such as gene editing – are required. Other forms of stem cell tools, such as organ-on-a-chip technology, can soon be built using a patient’s own cells and can make personalized predictions and serve as “avatars.”

3. Revolutionizing neuroscience using artificial intelligence (AI) to engineer advanced brain-interface systems Using AI, we have the opportunity to analyze the various states of the brain through everyday situations and real-world functioning to noninvasively pinpoint pathological brain function. Creating technology that does this is a monumental task, but one that is increasingly possible. Brain prosthetics, which supplement, replace or augment functions, can relieve the disease burden caused neurological conditions. Additionally, AI modeling of brain anatomy, physiology, and behavior, along with the synthesis of neural organoids, can unravel the complexities of the brain and bring us closer to understanding and treating these diseases.

4. Engineering the immune system for health and wellness With a heightened understanding of the fundamental science governing the immune system, we can strategically make use of the immune system to redesign human cells as therapeutic and medically invaluable technologies. The application of immunotherapy in cancer treatment provides evidence of the integration of engineering principles with innovations in vaccines, genome, epigenome and protein engineering, along with advancements in nanomedicine technology, functional genomics and synthetic transcriptional control.

5. Designing and engineering genomes for organism repurposing and genomic perturbations Despite the rapid advances in genomics in the past few decades, there are obstacles remaining in our ability to engineer genomic DNA. Understanding the design principles of the human genome and its activity can help us create solutions to many different diseases that involve engineering new functionality into human cells, effectively leveraging the epigenome and transcriptome, and building new cell-based therapeutics. Beyond that, there are still major hurdles in gene delivery methods for in vivo gene engineering, in which we see biomedical engineering being a component to the solution to this problem.

“These grand challenges offer unique opportunities that can transform the practice of engineering and medicine,” remarked Dr. Shankar Subramaniam, lead author of the taskforce, distinguished professor, Shu Chien-Gene Lay Department of Bioengineering at the University of California San Diego and past President of IEEE EMBS. “Innovations in the form of multi-scale sensors and devices, creation of humanoid avatars and the development of exceptionally realistic predictive models driven by AI can radically change our lifestyles and response to pathologies. Institutions can revolutionize education in biomedical and engineering, training the greatest minds to engage in the most important problem of all times – human health.”

This article was adapted with permission from an original version published by the IEEE Engineering in Medicine and Biology Society.

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