18 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

    Um simulador dinâmico do crescimento de uma cultura de cana-de-açúcar A dynamic simulator of the sugarcane crop growth

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    Este trabalho descreve a primeira versão de um simulador matemático-fisiológico do crescimento diário de uma cultura de cana-de-açúcar (SIMCANA) em resposta às condições do ambiente durante a estação de crescimento. SIMCANA resume a maior parte das informações disponíveis concernentes aos processos fisiológicos da cultura de cana-de-açúcar. Esta sua versão não incluí os processos degerminação e florescimento, havendo necessidade de especificar as condições da cultura no primeiro dia de simulação. Em função das condições diárias de radiação solar global, temperatura máxima e mínima, umidade relativa do ar, SIMCANA calcula as taxas de fotossíntese, respiração e crescimento da cultura, as taxas de senescência das folhas e raízes, a massa seca das folhas, colmos e raízes, e o índice de área foliar. Embora várias relações empíricas tenham sido usadas, SIMCANA parece ser capaz de simular o crescimento da cultura de cana-de-açúcar.<br>The first version of a mathematical-physiological simulator of the daily growth of a sugarcane crop (SIMCANA) as a function of the environmental conditions during the growing season is described. SIMCANA summarizes most of the available information regarding to the physiological processes of the sugarcane crop. This version does not include the germination and flowering processes, therefore it is necessary to specify the crop conditions at the first day of simulation. Given the daily conditions of global solar radiation, maximum and minimum temperature, and the relative humidity, SIMCANA computes the rates of crop photosynthesis, respiration, and growth, the senescence rates for leaves and roots, the dry mass of leaves, stems, and roots, and the leaf area index. Although several empirical relations have been used, SIMCANA seems to be able to simulate the sugarcane crop growth
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