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

Electronic Transport In Disordered Mos2 Nanoribbons

We study the electronic structure and transport properties of zigzag and armchair monolayer molybdenum disulfide nanoribbons using an 11-band tight-binding model that accurately reproduces the material\u27s bulk band structure near the band gap. We study the electronic properties of pristine zigzag and armchair nanoribbons, paying particular attention to the edges states that appear within the MoS2 bulk gap. By analyzing both their orbital composition and their local density of states, we find that in zigzag-terminated nanoribbons these states can be localized at a single edge for certain energies independent of the nanoribbon width. We also study the effects of disorder in these systems using the recursive Green\u27s function technique. We show that for the zigzag nanoribbons, the conductance due to the edge states is strongly suppressed by short-range disorder such as vacancies. In contrast, the local density of states still shows edge localization. We also show that long-range disorder has a small effect on the transport properties of nanoribbons within the bulk gap energy window

Development of maize and palisadegrass plants cultivated in intercrop under water deficit

The objective of this work was to evaluate the development and productive traits of palisadegrass single cultivated or intercropped with corn, in addition to corn intercropped with pasture, under water deficit at different development stages of the plants. It was used a complete block experimental design with split plots and three replicates. Periods of water deficit were placed in the plots and types of cultivation were placed in the subplots. Irrigation was stopped at germination and initial tillering of palisadegrass and at V4 and V15 stages of corn and returned when soil moisture was 40% of available water capacity. Tiller density and palisadegrass height were evaluated weekly. Dry matter (DM) of fractions of herbage mass as well as leaf area of the plants were evaluated at corn tasseling and when grains reached physiological maturity. Components of corn production were determined in the second sampling. In palisadegrass, water influenced only tillering, which was reduced in the plots in which water defict was forced at the moment of germination or at the beginning of tilering, in both cultivation systems. Plant height and DM production were affected only by cultivation, reducing when intercropped with corn. Evaluated production components did not influence corn grain productivity, which was similar in all treatments (average of 10,145 kg/ha). Palisadegrass plants produce more DM in single cultivation than intercropped with corn. Water deficit during germination and initial tillering reduces tillering of palisadegrass during establishment phase. Water deficit, applied in this trial, does not reduce DM yield in palisadegrass or corn