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

A New Multistep Chemical Treatment Method for High Performance Natural Fibers Extraction

A new chemical treatment method to extract rich cellulosic fibers from date palm agro-residues is developed. The method yielded high-performance natural date palm fibers based on multistep process, which is efficient, sustainable, and unique. The proposed method consists of three steps: dewaxing, acetylation, and mercerization, which are unique in terms of time control and their sequence resulting in optimal properties of extracted fiber. Each step is strictly time-controlled and designed to achieve specific objectives in preparation for the next step. Optimization techniques including design of experiment are used to adjust input parameters so as to obtain optimized output from the treatment method. Two approaches are used for supplying heat during the fiber extraction procedure i.e. conventional heat source and microwave heat source. Experimental characterization of extracted fibers is carried out to determine its mechanical and physical properties. Results showed 32% increase in crystallinity degree of the treated fiber over the untreated one. The new method achieved around five-fold increase in ultimate tensile strength and three-fold increase in elastic modulus. The significant enhancement in properties of treated fibers over untreated counterparts confirms the effectiveness of the new process

Optimization of surface roughness in micro-high speed end milling of soda lime glass using uncoated tungsten carbide tool with compressed air blowing

Soda lime glass is a very important material in diverse manufacturing industries, including automotive, electronics, and aerospace. In these applications, the glass surface needs to be defect free and without impurities. However, the machining of glass is difficult due to its inherent brittleness which leads to brittle fracture and easy crack propagation. This research investigates the high speed micro-end milling of soda lime glass in order to attain ductile regime machining. It has been found by other researchers that ductile mode machining can avoid brittle fracture and subsurface cracks. Also, in this study, a special air delivery nozzle is used to blow away the resultant chips and keep the machined surface clean. To accomplish this, Design Expert software and a commercial NC end mill were used to design and perform the machining runs, respectively. The surface roughness of the resultant surfaces was later analyzed with a surface profilometer. Microphotographs of the machined surfaces were also taken in order to see how effective the air blowing method is. The results of surface roughness measurements were then used to develop a quadratic empirical model for surface finish prediction. Finally, desirability function and genetic algorithms were used to predict the best combination of cutting parameters needed to obtain the lowest surface roughness. The predictions were later tested by experiments. The results demonstrate that this type of machining is viable and the roughness obtained is very low at 0.049 μm

Achievement of ductile regime machining in high speed end milling of soda lime glass by using tungsten carbide tool insert

Soda lime glass is widely used in optics, chemical apparatus, camera lens, micro gas turbines, light bulbs etc. on account of its high hardness, corrosion resistance, and excellent optical properties. These require high dimensional accuracy and flawless surface finish. However, soda lime glass is inherently brittle leading to subsurface crack propagation and fracture which compromise its functionality. To avoid these defects, the machining needs to be performed under ductile mode conditions. Therefore, this research investigates the viability and requisite conditions for achieving ductile regime machining(DRM) in high speed micro-end milling of soda lime glass. Machining was performed at high cutting speeds (30,000 to 50,000 rpm), feed rate (5 to 15 mm/min), and depth of cut (3 to 7 μm). A surface profilometer was then used to measure the surface roughness and a scanning electron microscope (SEM) used to scrutinize the resultant machined surfaces. The results demonstrate that ductile streaks and rounded gummy chips (without sharp or jagged edges) are produced in all runs. In addition, there are no subsurface cracks and the minimum surface roughness attained is 0.08μm. These indicate that DRM of soda lime glass is obtainable using high-speed micro end milling in a conventional end mill with tungsten carbide inserts

Effect of cutter diameters on surface roughness attained in high speed end milling of soda lime glass

Soda lime glass is used extensively in camera lens, micro gas turbines, light bulbs, tablewares, optics, and chemical apparatus owing to its high hardness, excellent optical properties, and good corrosion and chemical resistance. Such applications of soda lime glass demand high machining and finishing precision. On the other hand, machining of glass poses significant challenges due to its inherent brittleness. The process of removal of material from glass, if not done in ductile mode, can generate subsurface cracks and brittle fractures which have adverse effects on its functionality. This research investigates the high speed micro-end milling of soda lime glass in order to obtain ductile regime machining. It has been found by other researchers that ductile mode machining can avoid sub-surface cracks and brittle fractures. However, in ductile mode machining, the gummy chips settle permanently on the machined surface affecting adversely the surface finish. In order to avoid such chip settlement, compressed air was directed using a special air delivery nozzle to blow away the resultant gummy chips, thereby preventing them from settling on the machined surface. Response surface methodology (RSM) and a commercial NC end mill were used to design and perform the machining runs, respectively. Machining was done using: high spindle speeds from 30,000 to 50,000 rpm, feed rates from 5 to 15 mm/min, and depth of cuts from 3 to 7 μm. Three different diameter carbide tools were used: 0.5, 1, and 2 mm. A surface profilometer was used to analyze the surface roughness of the resultant machined surface. Subsequently, the data was used for finding the best combination of cutting parameters required to obtain the lowest surface roughness. The results demonstrate that high speed machining is a viable option for obtaining ductile regime machining and generating machined surfaces with very low surface roughness in the range of 0.08μm – 0.22 μm, using 0.5 mm carbide end mill cutter