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

The PHEMU15 catalogue and astrometric results of the Jupiter's Galilean satellite mutual occultation and eclipse observations made in 2014-2015

During the 2014-2015 mutual events season, the Institut de Mécanique Céleste et de Calcul des Éphémérides (IMCCE), Paris, France, and the Sternberg Astronomical Institute (SAI), Moscow, Russia, led an international observation campaign to record ground-based photometric observations of Galilean moon mutual occultations and eclipses.We focused on processing the complete photometric observations data base to compute new accurate astrometric positions. We used our method to derive astrometric positions from the light curves of the events. We developed an accurate photometric model of mutual occultations and eclipses, while correcting for the satellite albedos, Hapke's light scattering law, the phase effect, and the limb darkening. We processed 609 light curves, and we compared the observed positions of the satellites with the theoretical positions from IMCCE NOE-5-2010-GAL satellite ephemerides and INPOP13c planetary ephemeris. The standard deviation after fitting the light curve in equatorial positions is ±24 mas, or 75 km at Jupiter. The rms (O-C) in equatorial positions is ±50 mas, or 150 km at Jupiter. © 2017 The Author(s)