Need for standardization of the measurement of preoperative weight in bariatric surgical patients in the UK: A survey of British Obesity and Metabolic Surgery Society (BOMSS) members

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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

Improving robustness of complex networks via the effective graph resistance

Improving robustness of complex networks is a challenge in several application domains, such as power grids and water management networks. In such networks, high robustness can be achieved by optimizing graph metrics such as the effective graph resistance, which is the focus of this paper. An important challenge lies in improving the robustness of complex networks under dynamic topological network changes, such as link addition and removal. This paper contributes theoretical and experimental findings about the robustness of complex networks under two scenarios: (i) selecting a link whose addition maximally decreases the effective graph resistance; (ii) protecting a link whose removal maximally increases the effective graph resistance. Upper and lower bounds of the effective graph resistance under these topological changes are derived. Four strategies that select single links for addition or removal, based on topological and spectral metrics, are evaluated on various synthetic and real-world networks. Furthermore, this paper illustrates a novel comparison method by considering the distance between the added or removed links, optimized according to the effective graph resistance and the algebraic connectivity. The optimal links are different in most cases but in close proximity