Surgery and COVID-19: Balancing the nosocomial risk a french academic center experience during the epidemic peak

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Self-assembly of Silver Nanoparticles and Multiwall Carbon Nanotubes on Decomposed GaAs Surfaces

Atomic Force Microscopy complemented by Photoluminescence and Reflection High Energy Electron Diffraction has been used to study self-assembly of silver nanoparticles and multiwall carbon nanotubes on thermally decomposed GaAs (100) surfaces. It has been shown that the decomposition leads to the formation of arsenic plate-like structures. Multiwall carbon nanotubes spin coated on the decomposed surfaces were mostly found to occupy the depressions between the plates and formed boundaries. While direct casting of silver nanoparticles is found to induce microdroplets. Annealing at 300°C was observed to contract the microdroplets into combined structures consisting of silver spots surrounded by silver rings. Moreover, casting of colloidal suspension consists of multiwall carbon nanotubes and silver nanoparticles is observed to cause the formation of 2D compact islands. Depending on the multiwall carbon nanotubes diameter, GaAs/multiwall carbon nanotubes/silver system exhibited photoluminescence with varying strength. Such assembly provides a possible bottom up facile way of roughness controlled fabrication of plasmonic systems on GaAs surfaces

Functional outcomes in symptomatic versus asymptomatic patients undergoing incisional hernia repair: Replacing one problem with another? A prospective cohort study in 1312 patients

Background: Incisional hernias can be associated with pain or discomfort. Surgical repair especially mesh reinforcement, may likewise induce pain. The primary objective was to assess the incidence of pain after hernia repair in patients with and without pre-operative pain or discomfort. The secondary objectives were to determine the preferred mesh type, mesh location and surgical technique in minimizing postoperative pain or discomfort. Materials and methods: A registry-based prospective cohort study was performed, including patients undergoing incisional hernia repair between September 2011 and May 2019. Patients with a minimum follow-up of 3–6 months were included. The incidence of hernia related pain and discomfort was recorded perioperatively. Results: A total of 1312 patients were included. Pre-operatively, 1091 (83%) patients reported pain or discomfort. After hernia repair, 961 (73%) patients did not report pain or discomfort (mean follow-up = 11.1 months). Of the pre-operative asymptomatic patients (n = 221), 44 (20%, moderate or severe pain: n = 14, 32%) reported pain or discomfort after mean follow-up of 10.5 months. Of those patients initially reporting pain or discomfort (n = 1091), 307 (28%, moderate or severe pain: n = 80, 26%) still reported pain or discomfort after a mean follow-up of 11.3 months postoperatively. Conclusion: In symptomatic incisional hernia patients, hernia related complaints may be resolved in the majority of cases undergoing surgical repair. In asymptomatic incisional hernia patients, pain or discomfort may be induced in a considerable number of patients due to surgical repair and one should be aware if this postoperative complication

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

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

Ion implantation induced damage in relaxed Si_1-xGe_x

Relaxed Si1-xGex layers with germanium contents of 0.04, 0.13, 0.24 and 0.36 have been grown by MBE and implanted under tightly controlled conditions with 2 MeV Si+ ions over the dose range 1×1010 to 5×1010 Si+ cm-2. The introduction rate and characteristics of simple defects have been investigated by EPR and DLTS whilst the accumulation of this damage with increasing dose has been followed by RBS, XTEM and optical depth profiling up to the onset of amorphisation. It is found that the integrated damage increases whilst the critical dose for amorphisation decreases with increasing Ge content.</p

Ion implantation induced damage in relaxed Si_1-xGe_x

Relaxed Si1-xGex layers with germanium contents of 0.04, 0.13, 0.24 and 0.36 have been grown by MBE and implanted under tightly controlled conditions with 2 MeV Si+ ions over the dose range 1×1010 to 5×1010 Si+ cm-2. The introduction rate and characteristics of simple defects have been investigated by EPR and DLTS whilst the accumulation of this damage with increasing dose has been followed by RBS, XTEM and optical depth profiling up to the onset of amorphisation. It is found that the integrated damage increases whilst the critical dose for amorphisation decreases with increasing Ge content.</p