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

Hemoglobin levels in persons with depressive and/or anxiety disorders

Objective: Both low and high hemoglobin levels lead to more physical diseases, and both are linked to mortality. Low hemoglobin, often classified as anemia, has also been linked to more depressive symptoms, but whether both hemoglobin extremes are associated with depressive disorder and potentially also with anxiety disorder has not been examined before. This study examines to which extent hemoglobin levels are associated with depression and anxiety disorders in a large cohort. Methods: The study sample consisted of 2920 persons from the Netherlands Study of Depression and Anxiety. Hemoglobin levels were determined after venipuncture. Depressive and anxiety disorders were determined according to a DSM-IV-based psychiatric interview. Clinical psychiatric characteristics included the severity of depression and anxiety, the duration of symptoms, the age of onset and the antidepressant use. Results: Higher hemoglobin levels were found in those with current depressive and/or anxiety disorders after sociodemographic adjustment and both higher, and lower hemoglobin levels were found in persons with higher depression and anxiety severity. However, after full adjustment for sociodemographics, disease indicators and lifestyle, associations were no longer significant. Conclusions: This cohort study showed that there is no independent association between depressive and/or anxiety disorders and hemoglobin levels or anemia status. © 2014 Elsevier Inc

Picosecond time-resolved bleaching dynamics of self-assembled quantum dots

Picosecond bleaching dynamics of vertically stacked self-assembled quantum dots (QDs) is investigated by means of time-resolved pump-probe differential reflection spectroscopy (TRDR) at room temperature (RT). We observe that the absorption spectrum, which represents the QD density of states at RT, is strongly shifted with respect to the photoluminescence spectrum. This shift can not be interpreted by carrier emission and re-trapping alone. TRDR allows us to study the dynamics of the pump generated carriers within the QDs. From the time-resolved measurements, we detect that the bleaching decay time has a strong energy dependence and is dominated by radiative and nonradiative recombination at low energy and by carrier emission at high energy

Picosecond time-resolved bleaching dynamics of self-assembled quantum dots

Picosecond bleaching dynamics of vertically stacked self-assembled quantum dots (QDs) is investigated by means of time-resolved pump-probe differential reflection spectroscopy (TRDR) at room temperature (RT). We observe that the absorption spectrum, which represents the QD density of states at RT, is strongly shifted with respect to the photoluminescence spectrum. This shift can not be interpreted by carrier emission and re-trapping alone. TRDR allows us to study the dynamics of the pump generated carriers within the QDs. From the time-resolved measurements, we detect that the bleaching decay time has a strong energy dependence and is dominated by radiative and nonradiative recombination at low energy and by carrier emission at high energy

Picosecond time-resolved bleaching dynamics of self-assembled quantum dots

Picosecond bleaching dynamics of vertically stacked self-assembled quantum dots is investigated by means of time-resolved pump-probe differential reflection spectroscopy at room temperature. This allows us to study the dynamics of the pump generated carriers within the quantum dots. We observe that the absorption spectrum is shifted over 12 meV with respect to the photoluminescence spectrum. From the time-resolved measurements we detect that the carrier lifetime within the dots strongly depends on the energy within the absorption spectrum

Time-resolved pump-probe characterization of the carrier dynamics in self-assembled quantum dots

Abstract only

Time-resolved pump-probe characterization of the carrier dynamics in self-assembled quantum dots

Abstract only