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

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

Internet of things enabled real time cold chain monitoring in a container port

Seaports are regarded as significant actors in global logistics and supply chains since a large part of the cargoes carried over the globe are being processed there. When the cold chain broken down during transport and storage in the ports, the humidity, nutrition, temperature and time conditions to be required for the growth of the bacteria occur, and rapid reproduction occurs and the properties of the products are rapidly deteriorating. It is imperative that especially medicines, some chemical substances and foodstuffs need to be transported without breaking the cold chain in the logistics. The monitoring and control of the temperature and humidity level is important in the time period between the loading of these containers in special areas in ports, the loading of freight in open areas, or the loading of freight on roads and railway carriages. For this reason, precise monitoring and control of the system is vital in the port logistics management

Deep-Learning-Based Floor Path Model for Route Tracking of Autonomous Vehicles

Real-time route tracking is an important research topic for autonomous vehicles used in industrial facilities. Traditional methods such as copper line tracking on the ground, wireless guidance systems, and laser systems are still used in route tracking. In this study, a deep-learning-based floor path model for route tracking of autonomous vehicles is proposed. A deep-learning floor path model and algorithm have been developed for highly accurate route tracking, which avoids collisions of vehicles and follows the shortest route to reach the destination. The floor path model consists of markers. Routes in the floor path model are created by using these markers. The floor path model is transmitted to autonomous vehicles as a vector by a central server. The server dispatches the target marker address to the vehicle to move. The vehicle calculates all possible routes to this address and chooses the shortest one. Marker images on the selected route are processed using image processing and classified with a pre-trained deep-CNN model. If the classified image and the image on the selected route are the same, the vehicle proceeds toward its destination. While the vehicle moves on the route, it sends the last classified marker to the server. Other autonomous vehicles use this marker to determine the location of this vehicle. Other vehicles on the route wait to avoid a collision. As a result of the experimental studies we have carried out, the route tracking of the vehicles has been successfully achieved

An ANP-based assessment model for lean enterprise transformation

There is a multitude of methodology on evaluation of lean transformation, but only few consider the relationships among the components of the lean enterprise transformation explicitly and focus on their prioritization and identification of the relative importance weights for every element of the lean transformation. For that reason, we try to quantify those relationships in this study. For a structured examination of the relationships among the elements, we suggest a model that provides a holistic view to the lean transformation process. This paper presents an analytic lean enterprise transformation modeling approach to the identification of weights of the organization's lean transformation determinants. Thus, the highly qualitative relationships among the lean transformation components are operationalized. For determining of the relative importance weights for every element in the model, analytic network process modeling approach is used in the proposed framework. This approach has enabled us to apply the proposed lean enterprise transformation methodology at a global industrial manufacturing company in Turkey, and an illustrative case is presented

Inflammatory Bowel Disease Presenting with Only Joint Involvement

Inflammatory bowel disease is an idiopathic and chronic intestinal inflammation. The major symptoms of the disease are diarrhea, rectal bleeding, tenesmus, passage of mucus, and crampy abdominal pain. The severity of the symptoms correlates with the extent of the disease. Peripheral arthritis is one of the extraintestinal manifestations of inflammatory bowel disease and is detected in about 15-20% of patients. It is usually asymmetric, polyarticular, and affects migratory large joints. In this report we describe a case of inflammatory bowel disease associated with symmetric, polyarticular, small-joint involvement. The patient was an 18-year-old male who had not been diagnosed for five months because of the absence of gastrointestinal symptoms. Colonoscopic biopsy results were compatible with inflammatory bowel disease

Inflammatory Bowel Disease Presenting with Only Joint Involvement

Inflammatory bowel disease is an idiopathic and chronic intestinal inflammation. The major symptoms of the disease are diarrhea, rectal bleeding, tenesmus, passage of mucus, and crampy abdominal pain. The severity of the symptoms correlates with the extent of the disease. Peripheral arthritis is one of the extraintestinal manifestations of inflammatory bowel disease and is detected in about 15-20% of patients. It is usually asymmetric, polyarticular, and affects migratory large joints. In this report we describe a case of inflammatory bowel disease associated with symmetric, polyarticular, small-joint involvement. The patient was an 18-year-old male who had not been diagnosed for five months because of the absence of gastrointestinal symptoms. Colonoscopic biopsy results were compatible with inflammatory bowel disease

PROCESS PLANNING AND WEIGHTED SCHEDULING WITH WNOPPT WEIGHTED DUE-DATE ASSIGNMENT USING HYBRID SEARCH FOR WEIGHTED CUSTOMERS

Although scheduling with due date assignment and, integrated process planning and scheduling are two popular topics studied by researchers, there are few works on the integration of process planning, scheduling, and due date assignment. In this study integration of process planning and scheduling with the weighted due date, the assignment is studied. Different level of integration of these three functions is tested. As a solution techniques random search and hybrid search are applied. The hybrid search starts with random search and continues with the genetic search. Search results are compared with ordinary solutions and searches are found very useful and hybrid search outperformed random search. Hybrid search with full integration combination found as the best combination.&nbsp