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

Limit Analysis and Concrete Plasticity : Third Edition

First published in 1984, Limit Analysis and Concrete Plasticity explains for advanced design engineers the principles of plasticity theory and its application to the design of reinforced and prestressed concrete structures, providing a thorough understanding of the subject, rather than simply applying current design formulas. Updated and revised throughout, Limit Analysis and Concrete Plasticity, Third Edition adds— Reinforcement design formulas for three-dimensional stress fields that enable design of solid structures (also suitable for implementation in computer-based lower bound optimizations) Improved explanations of the crack sliding theory and new solutions for beams with arbitrary curved shear cracks, continuous beams, lightly shear reinforced beams and beams with large axial compression More accurate treatment of and solutions for beams with circular cross-section Applications of crack sliding theory to punching shear problems New solutions that illustrate the implication of initial cracking on load-carrying capacity of disks Yield condition for the limiting case of isotropically cracked disk The authors also devote an entirely new chapter to a recently developed theory of rigid-plastic dynamics for seismic design of concrete structures. In comparison with time-history analyses, the new theory is simpler to use and leads to large material savings. With this chapter, plasticity design methods for both statical and dynamical loads are now covered by the book

Participation and influence of REDD+ actors in Vietnam, 2011–2019

Reducing emissions from deforestation and degradation (REDD+) is an important component of the Paris Agreement. Inclusive decision making is essential to ensure REDD outcomes, but there is limited anecdotal and empirical evidence demonstrating that stakeholder participation in REDD+ decision making has improved over time. This paper presents an analysis of the Vietnamese government’s claim that stakeholder participation in REDD+ had been improved over the course of 2011–2019, specifically focusing on various actors’ perceptions of their level of interest, engagement and influence in REDD+ policy events. Findings show that the country’s legal framework on REDD+ demonstrated Vietnam’s political commitment to improve inclusive decision making, and initial effort was made to provide political space for actors to engage in REDD+ decision making. However, momentum has been lost over time. This suggests that understanding the political context, addressing underlying power dynamics in the existing government regime, building up coalitions for change among political elites and civil society, and fostering sustainable political will and commitment are all essential to ensuring inclusive REDD+ decision making in Vietnam

Selective hydrogenation of sunflower oil over supported precious metals

International audienceSelective hydrogenation of ethyl esters of traditional sunflower oil was carried out at low temperature (40 degreesC) in the presence of supported monometallic catalysts containing noble metals Pd, Pt or Ru. The palladium catalysts prove to be the most active, but isomerisation is quite important. The selectivity in cis C18:1 ester was improved by the modification of the palladium catalysts by copper and lead. or by addition of amines into the reaction medium

An efficient time-domain implementation of the multichromophoric Förster resonant energy transfer method

The excitation energy transfer (EET) process for photosynthetic antenna complexes consisting of subunits, each comprised of multiple chromophores, remains challenging to describe. The multichromophoric Förster resonance energy transfer theory is a popular method to describe the EET process in such systems. This paper presents a new time-domain method for calculating energy transfer based on the combination of multichromophoric Förster resonance energy transfer theory and the Numerical Integration of the Schrödinger Equation method. After validating the method on simple model systems, we apply it to the Light-Harvesting antenna 2 (LH2) complex, a light harvesting antenna found in purple bacteria. We use a simple model combining the overdamped Brownian oscillators to describe the dynamic disorder originating from the environmental fluctuations and the transition charge from the electrostatic potential coupling model to determine the interactions between chromophores. We demonstrate that with this model, both the calculated spectra and the EET rates between the two rings within the LH2 complex agree well with experimental results. We further find that the transfer between the strongly coupled rings of neighboring LH2 complexes can also be well described with our method. We conclude that our new method accurately describes the EET rate for biologically relevant multichromophoric systems, which are similar to the LH2 complex. Computationally, the new method is very tractable, especially for slow processes. We foresee that the method can be applied to efficiently calculate transfer in artificial systems as well and may pave the way for calculating multidimensional spectra of extensive multichromophoric systems in the future