11 research outputs found

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

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    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

    Rapid measurement of methyl cellulose precipitable Ttannins using ultraviolet spectroscopy with chemometrics: application to red wine and inter-laboratory calibration transfer

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    Information relating to tannin concentration in grapes and wine is not currently available simply and rapidly enough to inform decision-making by grape growers, winemakers, and wine researchers. Spectroscopy and chemometrics have been implemented for the analysis of critical grape and wine parameters and offer a possible solution for rapid tannin analysis. We report here the development and validation of an ultraviolet (UV) spectral calibration for the prediction of tannin concentration in red wines. Such spectral calibrations reduce the time and resource requirements involved in measuring tannins. A diverse calibration set (n = 204) was prepared with samples of Australian wines of five varieties (Cabernet Sauvignon, Shiraz, Merlot, Pinot Noir, and Durif), from regions spanning the wine grape growing areas of Australia, with varying climate and soils, and with vintages ranging from 1991 to 2007. The relationship between tannin measured by the methyl cellulose precipitation (MCP) reference method at 280 nm and tannin predicted with a multiple linear regression (MLR) calibration, using ultraviolet (UV) absorbance at 250, 270, 280, 290, and 315 nm, was strong (r(2)val = 0.92; SECV = 0.20 g/L). An independent validation set (n = 85) was predicted using the MLR algorithm developed with the calibration set and gave confidence in the ability to predict new samples, independent of the samples used to prepare the calibration (r(2)val = 0.94; SEP = 0.18 g/L). The MLR algorithm could also predict tannin in fermenting wines (r(2)val = 0.76; SEP = 0.18 g/L), but worked best from the second day of ferment on. This study also explored instrument-to-instrument transfer of a spectral calibration for MCP tannin. After slope and bias adjustments of the calibration, efficient calibration transfer to other laboratories was clearly demonstrated, with all instruments in the study effectively giving identical results on a transfer set.Robert G. Dambergs, Meagan D. Mercurio, Stella Kassara, Daniel Cozzolino, and Paul A. Smit
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