Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Optimal control of a finite dam with diffusion input and state dependent release rates

AbstractIn this paper, we consider the optimal control of a finite dam using Pλ,τM policies; assuming that the dam has capacity v, the water input is a diffusion process reflected at 0, v. The release rates depend on the water content in the dam. There is a certain cost of maintaining the dam as well as a reward received. We obtain an explicit formulas for the total discounted cost over the infinite horizon as well as the long-run average cost per a unit of time

β-Oxo Anilides in Heterocyclic Synthesis: Novel Synthesis of Substituted Pyridazinones, Pyridine, Pyrimidines and Pyrazolotriazines A. M. Hussein et al

Abstrac

Fluorine substituted thiomethyl pyrimidine derivatives as efficient inhibitors for mild steel corrosion in hydrochloric acid solution: Thermodynamic, electrochemical and DFT studies

Three new 5-fluoro-2- methylthio substituted pyrimidine derivatives have been synthesized and characterized by H-1 NMR spectroscopy and Mass spectrometry. Corrosion inhibition characteristics of the synthesized pyrimidine derivatives have been studied on mild steel (MS) in 0.5 M hydrochloric acid solution at various temperatures (303-333 K) using mass loss and electrochemical techniques. The obtained weight loss, electrochemical impedance and potentiodynamic polarization data indicate that the corrosion inhibition efficiency is directly proportional to concentration of the inhibitors. The Adsorption process on MS surface obeyed Langmuir isotherm model. Scanning electron microscopy (SEM) was used to characterize surface morphology of the MS specimen in absence and presence of pyrimidine derivatives. Density functional theory (DFT) calculations using B3LYP functional with 6-311+G (d,p) level was used to establish the relationship between molecular structure and corrosion inhibition efficiency. Electrochemical analysis indicated that pyrimidine derivatives inhibit the corrosion by adsorbing on the metal surface. Mixed-type of corrosion inhibition activity with anodic predominance was proposed by polarization studies. (C) 2020 Elsevier B.V. All rights reserved