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

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

Abstract 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

White Paper on Light Sterile Neutrino Searches and Related Phenomenology

International audienceThis white paper provides a comprehensive review of our present understanding of experimental neutrino anomalies that remain unresolved, charting the progress achieved over the last decade at the experimental and phenomenological level, and sets the stage for future programmatic prospects in addressing those anomalies. It is purposed to serve as a guiding and motivational "encyclopedic" reference, with emphasis on needs and options for future exploration that may lead to the ultimate resolution of the anomalies. We see the main experimental, analysis, and theory-driven thrusts that will be essential to achieving this goal being: 1) Cover all anomaly sectors -- given the unresolved nature of all four canonical anomalies, it is imperative to support all pillars of a diverse experimental portfolio, source, reactor, decay-at-rest, decay-in-flight, and other methods/sources, to provide complementary probes of and increased precision for new physics explanations; 2) Pursue diverse signatures -- it is imperative that experiments make design and analysis choices that maximize sensitivity to as broad an array of these potential new physics signatures as possible; 3) Deepen theoretical engagement -- priority in the theory community should be placed on development of standard and beyond standard models relevant to all four short-baseline anomalies and the development of tools for efficient tests of these models with existing and future experimental datasets; 4) Openly share data -- Fluid communication between the experimental and theory communities will be required, which implies that both experimental data releases and theoretical calculations should be publicly available; and 5) Apply robust analysis techniques -- Appropriate statistical treatment is crucial to assess the compatibility of data sets within the context of any given model

White Paper on Light Sterile Neutrino Searches and Related Phenomenology

This white paper provides a comprehensive review of our present understanding of experimental neutrino anomalies that remain unresolved, charting the progress achieved over the last decade at the experimental and phenomenological level, and sets the stage for future programmatic prospects in addressing those anomalies. It is purposed to serve as a guiding and motivational "encyclopedic" reference, with emphasis on needs and options for future exploration that may lead to the ultimate resolution of the anomalies. We see the main experimental, analysis, and theory-driven thrusts that will be essential to achieving this goal being: 1) Cover all anomaly sectors -- given the unresolved nature of all four canonical anomalies, it is imperative to support all pillars of a diverse experimental portfolio, source, reactor, decay-at-rest, decay-in-flight, and other methods/sources, to provide complementary probes of and increased precision for new physics explanations; 2) Pursue diverse signatures -- it is imperative that experiments make design and analysis choices that maximize sensitivity to as broad an array of these potential new physics signatures as possible; 3) Deepen theoretical engagement -- priority in the theory community should be placed on development of standard and beyond standard models relevant to all four short-baseline anomalies and the development of tools for efficient tests of these models with existing and future experimental datasets; 4) Openly share data -- Fluid communication between the experimental and theory communities will be required, which implies that both experimental data releases and theoretical calculations should be publicly available; and 5) Apply robust analysis techniques -- Appropriate statistical treatment is crucial to assess the compatibility of data sets within the context of any given model