Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract 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

Energy, exergy, economic and environmental (4E) analyses of flat-plate and V-groove solar air collectors based on aluminium and copper

An experimental investigation has been carried out to study the effect of energy, economic, and environment of SACs which are smooth and roughened by v-groove protrusions arranged made of copper and aluminium materials. In this context; energy, exergy, economic, and environment (4E) analyses are investigated using data obtained from experimental studies at air mass flow rates of 0.04, 0.06, 0.08 and 0.1 kg/s. Thermal, economic, and environmental impacts for performance enhancement of the SACs have been determined. It reveals that the average thermal and exergy efficiencies of the SACs, for the installed region of collectors, were 43–60% and 6–12%, respectively. Among all others with copper v-groove showed that the highest heat transfer enhancements with friction factors high than those of flat, thermal performance of copper v-groove are among the highest of the SACs tested in this study. The payback period was found to be between average 4.3 and 4.6 years when calculated on a yearly basis, which was significantly less than estimated lifetime of the system. The enviro-economic cost values were obtained between 4.5 and 5.77 $/year. Consequently, the results show that the v-groove collectors to be preferable due to their performance despite the price disadvantage. The v-groove SACs, although slightly higher friction factors and cost, produce much higher heat transfer coefficients compared with flat SACs. © 2017 Elsevier Lt

The effect of blowing direction on heat sink performance by thermal imaging

Heat sinks (HSs) are designed for the mechanical, electrical and electronic components that generate heat in considerable amount. For this purpose, an aluminum conical pin fin heat sink is designed. Aluminum conical pin-fins geometry has been experimentally investigated for the blowing direction (pushing or pulling) which is the energy efficient option for the heat sink. The heat sink was tested at the same fan power for pushing and pulling conditions for 25, 50, 75 and 100 W resistance heater power. Designed aluminum conical pin fin heat sink can be easily used in heat sweeping processes. It has found that pushing configuration of the fan is more efficient for this design. © 2018 Yildiz Technical University

Experimental performance analysis of sensible heat storage in solar air collector with cherry pits/powder under the natural convection

It is important to enhance the availability of SACs either in cloudy weather or after sunset for space heating and agricultural drying process. In this context, this study aims to determine experimentally thermal performance of cherry pits as sensible heat storage material under natural convection conditions. In the first collector (Type I), powdered cherry pits (32 kg) were used as heat storage material and cherry pits (24 kg) were used in the second (Type II). The third collector (Type III) with a flat absorber plate is for comparison. Although the maximum thermal efficiencies were found 26.54% and 27.03% for Type I and Type II respectively, average thermal efficiency of Type I is higher than Type II. According to the test results, the inlet-outlet temperatures were equalized 46 min for the Type III, 200 min for Type II, and 270 min for Type I collector after sunset. As a result, it can be said that the use of cherry pits and powder as sensible heat storage material is promising. © 2018 Elsevier Lt

Bir Güneş Destekli Isı Pompalı Kurutucuda Mantarın Kurutma Davranışlarının Yapay Sinir Ağı Kullanılarak Modellenmesi

Kurutucu, güneş enerjisi ile ve güneş enerjisi destekli ısı pompası ile ayrı ayrı 45 °C ve 55 °C kurutma havası sıcaklığı ve 0.9 m s-1 hava hızında mantar kurutularak test edilmiştir. Deneylerden elde edilen nem içeriği (MC), ayrılabilir nem oranı (MR) ve kuruma hızı (DR) değerleri Levenberg-Marquardt (LM) geri yayılım öğrenme algoritması ve Fermi transfer fonksiyonu kullanılarak yapay sinir ağları (YSA) ile modellenmiştir. Geliştirilen modelin istatistiksel geçerliliğinin belirlenmesinde kullanılan çoklu saptama katsayısı (R2), ortalama karekök (RMSE), ve mutlak hata yüzdesi (MAPE) istatistik değerleri kullanılmıştır. R2, RMSE ve MAPE sırasıyla MC için 0.999, 0.0078895, 0.2668459, MR için 0.999, 0.0001099, 0.2968427 ve DR için 0.999, 0.0000008, 0.2703797 olarak elde edilmiştir. Böylece, farklı kurutma şartları için bu modelleme ile mantarın kuruma davranışları başarılı bir şekilde analiz edilebilir

Difficult septal deviation cases: open or closed technique? [Casos difíceis de desvio septal: técnica aberta ou fechada?]

Introduction The aim of this study is to compare the functional aspects of open technique (OTS) and endonasal septoplasty (ENS) in “difficult septal deviation cases”. Methods 60 patients with severe nasal obstruction from S-shaped deformities, multiple deformities, high deviations etc. were included in the study. The OTS was used in 30 patients and the ENS was performed in 30 patients. The Nasal Obstruction Symptom Evaluation (NOSE) scale was administered preoperatively and at first month following surgery. Patients were also evaluated for pain postoperatively with Visual Analog Scale (VAS). Results The mean NOSE score was decreased 62.5–11.0 in the OTS group and 61.3–21.33 in the ENS group. Improvement of the symptoms following the two surgical techniques is similar and no statistically significant difference was found between both techniques. Also there was no statistically significant difference in postoperative pain between the OTS and ENS groups evaluated by VAS. Conclusion ENS is as successful as the OTS in management difficult septal deviation cases. In patients with severe septal deformities type of the surgical technique should be selected according to the surgeon's experience and the patient's preference. © 201