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

Towards a single theory for an improved equation of state for fluid sodium

SIGLEAvailable from British Library Document Supply Centre- DSC:DX88938 / BLDSC - British Library Document Supply CentreGBUnited Kingdo

An extratropical cyclone database: A tool for illustrating cyclone structure and evolution characteristics

Extratropical cyclone lifecycles have been studied extensively with the aim of understanding the dynamical mechanisms involved in their development. Previous work has often been based on subjective analysis of individual case studies. Such case studies have contributed heavily to the generation of conceptual models of extratropical cyclones that provide a framework for understanding the dynamical evolution of cyclones. These conceptual models are widely used in educational meteorology courses throughout the world to illustrate the basic structure and evolution of extratropical cyclones. This article presents a database of extratropical cyclone composites which highlight the average structure and evolution of 20 years of extratropical cyclones, as opposed to individual case studies. The composite fields are achieved by combining a database containing cyclone tracks from the ERA-Interim reanalysis (1989-2009, 6 hourly) with the full 3D ERA-Interim reanalysis fields. Vertical and horizontal composites of cyclone structure for cyclones generated in the Atlantic and Pacific regions identifying features such as the relative positions of cold, warm and occluded fronts and their associated wind and cloud patterns are shown. In addition the evolution of cyclonic flows such as the warm and cold conveyor belts and dry intrusion are illustrated. A webpage containing an archive of the composited data is freely available for educational purposes

Three-year follow-up of children with postmeningitic deafness and partial cochlear implant insertion.

Contains fulltext : 48495.pdf (publisher's version ) (Closed access)OBJECTIVES: To evaluate the long-term outcome of children with postmeningitic deafness and partial insertion of the Nucleus electrode array, and to compare their speech perception performance with that of children with full insertion of the electrode array. DESIGN: A battery of seven speech perception tests was administered to 25 children with a cochlear implant (CI). Results were reduced into one score: equivalent hearing loss (EHL). SETTING: Tertiary referral centre. PARTICIPANTS: The partial insertion group comprised seven children, mean age at implantation 5.5 years, mean duration of deafness 3.6 years. The full-insertion control group comprised 18 children. Mean age at implantation: 4.4 years; mean duration of deafness: 2.9 years. All the children became deaf between 0 and 3 years of age. MAIN OUTCOME MEASURES: Over a 3-year follow-up period, the children with partial insertion showed continuing progress, although there was wide variation in performance and the rate of progression. Some open-set comprehension could even be achieved with the insertion of only eight electrodes of a nucleus device. RESULTS: Three years after implantation, speech perception in the partial insertion children was poorer than that in the control groups with long (P < 0.01; 95% confidence interval 7-43 dB EHL) and short duration of deafness (P < 0.0001; 95% confidence interval 28-53 dB EHL). They showed slower progress and reached a poorer EHL plateau. Four of the seven children acquired open-set word recognition. CONCLUSIONS: Patients with partial insertion of the electrode array benefit from a CI, although less than patients with complete insertion

Entertainment computing, social transformation and the quantum field

Abstract. Entertainment computing is on its way getting an established academic discipline. The scope of entertainment computing is quite broad (see the scope of the international journal Entertainment Computing). One unifying idea in this diverse community of entertainment researchers and developers might be a normative position to enhance human living through social transformation. One possible option in this direction is a shared ‘conscious ’ field. Several ideas about a new kind of field based on quantum effects are presented and discussed. Assuming that social transformation is based on a shared collective unconscious I propose designing entertainment technology for a new kind of user experience that can transform in a positive manner the individual unconscious and therefore the collective unconscious as well. Our ALICE project can be seen as a first attempt in this direction. Key words: culture, social responsibility, entertainment, computing, quantum field