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

Genome-wide meta-analysis of macronutrient intake of 91,114 European ancestry participants from the cohorts for heart and aging research in genomic epidemiology consortium

Clinical epidemiolog

Search for a new weakly interacting particle

A search for events of the type e+e−→ℓ+ℓ−X0, where X0 can be any weakly interacting particle which couples to the Z, has been performed with the ALEPH detector at LEP, by searching for acollinear lepton pairs. Such particles can be excluded up to a mass of 7.0 GeV/c2 for a value of the ratio of branching fractions, Br(Z→X0l+l−)/Br(Z→l+l−), greater than 2.5 × 10−3 if the X0 has third component of isospin, I3 greater than and decays to a pair of virtual gauge bosons. When this analysis is combined with the previous results of the Higgs particle searches from ALEPH, this limit can be extended to an X0 mass of 60 GeV/c2

Measurement of isolated photon production in hadronic Z decays

The production of high energy isolated photons in hadronic Z decays is measured with the ALEPH detector at LEP using a sample of 180 000 hadronic events. Such photons are mainly radiated by quarks, thus giving direct insights into the early parton showering mechanism. The observed rate is compared with a QCD calculation of final state radiation from quarks

Measurement of charge asymmetry in hadronic Z decays

A significant charge asymmetry is observed in the hadronic Z decays with the ALEPH detector at LEP. The asymmetry expressed in terms of the difference in momentum weighted charges in the two event hemispheres is measured to be −= −0.0084±0.0015 (stat.) ±0.0004 (exp. sys.). In the framework of the standard model this can be interpreted as a measurement of the effective electroweak mixing angle, sin2Ow (Mz2=0.2300±0.0034 (stat.) ±0.0010 (exp. sys.) ±0.0038 (theor. sys.) or of the ratio of the vector to axual- vector coupling costants of the electron, gvegAe=+0.073±0.024

Production and decay of charmed mesons at the Z resonance

In a sample of 190 000 hadronic Z decays, three signals of charm production are observed: two from the exclusive decays and one in the transverse-momentum distribution of soft hadrons relative to the nearest jet. The features of these signals are in good agreement with expectations based on the standard model and previous measurements of the branching fractions. The number of per hadronic decay of the Z is measured to be (5.11±0.34) × 10−3, and the branching ratio B(D0 → K−π+) is (3.62 ± 0.34 ± 0.44)%. Charm hadronization has been studied. The average fraction of the beam energy carried by the D∗ meson is found to be 〈XE〉c = 0.504−0.017+0.013±0.008, and implications of the measurements on the pseudoscalar-to-vector production ratio of charmed mesons are discussed

Measurement of the forward - backward asymmetry in Z ---> b anti-b and Z ---> c anti-c

From a sample of 150 000 hadronic Z decays collected with the ALEPH detector at LEP, events containing prompt leptons are used to measure the forward-backward asymmetries for the channels and , giving the results AFBb=0.126±0.028±0.012 and AFBc=0.064±0.039±0.030. These asymmetries correspond to the value of effective electroweak mixing angle at the Z mass sin2θW(mZ2) = 0.2262±0.0053