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

Free-standing and binder-free nickel polymeric nanofiber membrane for electrocatalytic oxidation of ethanol in alkaline solution

In-situ chemical reduction technique was exploited to fabricate free-standing and binder-free active nanocatalyst materials for direct ethanol fuel cells using nickel nanoparticles onto polyvinylidenefluoride-co-hexafluoropropylene membrane [Ni/PVdF-HFP]. Homogeneously distributed nickel nanoparticles with face-centered cubic structure were observed onto smooth membrane surfaces. Cyclic voltammetric measurements indicated the enhanced activity of Ni/PVdF-HFP membrane for oxidizing the alcohol molecules in NaOH solution. The measured oxidation current density increased with increasing the added ethanol concentration into the supporting electrolyte up to 0.64 M. Some kinetic parameters were calculated such as the charge transfer coefficient (α), Tafel slope and exchange current density values to record 0.468, 369 mV dec−1 and 1.28 μA cm−2, respectively. The three dimensional nanostructure of these fabricated metallic membranes and the increased number of their active voids could provide largely exposed surface areas for adsorbed alcohol molecules. The good stability of nickel nanoparticles onto PVdF-HFP membrane surface with minimum leaching level during prolonged ethanol oxidation in alkaline solution can offer unique possibilities for utilizing these polymeric electrocatalyst structures for energy production applications

Experimental Analysis of Conditions Based Variations of Characteristics and Parameters of Photovoltaic Modules

This paper presents an experimental determination of the main and advanced characteristics of photovoltaic (solar-PV) modules as affected by variations in the solar irradiance and temperature. In addition, the effects of connecting modules in series, and in parallel are inspected. The measured main characteristics are the current/voltage (IV), and power/voltage (PV) relations, while the advanced characteristics include the form factor (FF), shunt resistance (Rsh), series resistance (Rs), characteristic resistance (Rch), and efficiency (). The impacts of the various levels of partial shading on the performance of the modules are also presented. Two identical 10 Wp modules are used in the tests. The sun’s energy is simulated using two lighting sources: One 1 kW halogen floodlight and four 100 W incandescent lamps. These light sources offer spectral which is very close to that of the black body radiation; however, they provide a lower color temperature in comparison with the sun. Therefore, they closely match the requirements of the IEC 60904-9 Edition2 and ASTM E927-10 standards of solar simulators. The electrical load is represented using two wound rheostats of 1200, and 500. The temperature is measured by a remote temperature sensor, while the electrical variables are measured using digital multi-meters. For cost reduction, the solar irradiance is estimated based on the linear relation between the short-circuit current, and the solar irradiance. The results are presented within the main text, and summarized in the conclusions section. It is found that the parameters such as Rs, Rsh, Rch, FF, and  are not constant, but they are highly dependent on the variations in the irradiance, and the temperature. The salient conclusion is that the standard equivalent circuit model of solar-PV modules that includes constant parameters needs to be significantly enhanced by considering the variations of the circuit parameters as affected by the variations in the solar irradiance and temperature.<br