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

Chemical composition of clays for pottery in Malaysia: a review

Pottery in Malaysia is been known for its utilized functions and unique properties. Clays as the pottery’s raw materials are a major factor that affecting the quality and reliability of some pottery products. Observations on clays’ elements and phases are very helpful for productions of the good pottery. Hence, in this review, chemical compositions of clays in terms of elements and phases structures are discussed. Basically, the most elements found in clays are Si, Al, Fe, Ti, K and Ca. Depends on location, the concentrations for those clays elements in Malaysia are at range of 24.8 – 32.4 for Si, 10.8 – 19.0 for Al, 0.09 – 2.12 for Fe, 0.08 – 1.13 for Ti and 0.45 – 3.39 for K. Several studies reported, they exist in form of oxide compound which are SiO2, Al2O3, Fe2O3, TiO2, MgO, CaO, Na2O, K2O and P2O5. The percentages of elements in clays do not only determine the clays characteristics, but also influence the physical, mechanical and chemical properties of the end product. Increase of major element like silica arises the melting point, lowers the fluidity, and enhances the hardness and tensile strength. Meanwhile, increase alumina content enables the green body to withstand the sintering temperature and also increase the hardness of the pottery

Mechanical, thermal and morphological properties of epoxy resin toughened with epoxidized soybean oil

Biobased toughened thermosetting polymer blend was prepared by incorporating epoxidized soybean oil (ESO) into a petroleum-based epoxy (DGEBA) in different composition ratios. The mechanical properties (tensile and flexural tests) of the ESO/DGEBA thermoset blends were determined. Thermal properties of the blends were characterized using thermogravimetric analysis. The result showed that, the tensile and flexural properties decreased with increasing of ESO content. However, a slight increase in the strength properties was observed at 10% of ESO content. A significant enhancement in impact strength proves the role of ESO acting as a plasticizer in the blends as well as improve the toughness properties of ESO/DGEBA thermoset blend. As the ESO content increase, the thermal stability of ESO/DGEBA thermoset blend has decreased might be due to reduced cross-linking density of the epoxy network. Further investigations on morphological properties were also done to correlate the mechanical properties of ESO/DGEBA thermoset blend