32 research outputs found

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

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    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

    GPR velocity and amplitude analyses to characterize stratigraphy and estimate the ice density: Easter Glacier of Mt. Canin, Italy

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    We propose a methodology to estimate the density of frozen media (snow, firn and ice) using common offset GPR data. The technique is based on reflection amplitude analysis to calculate series\u2019 of reflection coefficients that we used to estimate the dielectric permittivity of each layer. Applying an empirical equation we determine the vertical density variations for all the acquired GPR traces and, therefore, infer the nature of frozen materials, from fresh snow, to granular snow, firn and ice, and to estimate the snow water equivalent (SWE), which is an essential parameter to determine the actual water volume within a certain frozen body. The proposed technique was tested in the Eastern Glacier of Mt. Canin (Eastern Alps) and validated by direct snow density measurements, obtained using samples collected from manually dug snow pits, and with data from the literature. Despite the necessary approximations, the average value of density for different levels is calculated with acceptable accuracy. Moreover, this analysis can help to find and locate debris or moraines embedded within the ice bodies

    Velocity analysis from common offset GPR data inversion: Theory and application to synthetic and real data

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    We implemented a procedure to estimate the electromagnetic (EM) velocity using common offset ground penetrating radar (GPR) data. The technique is based on the inversion of reflection amplitudes to compute the series of reflection coefficients used to estimate the velocity in each interpreted layer. The proposed method recursively calculates the incident angles at any interface, taking into account the offset between antennas, and needs as input, in addition to the picked amplitudes values, a reference amplitude for each analysed GPR trace and a velocity value for the first (shallowest) layer. The latter two parameters can be estimated directly from the available data or can be better constrained by further dedicated GPR acquisitions or by additional direct measurements. We critically evaluated the performances for both synthetic and real data acquired with different antenna frequencies and we demonstrated that the new method can be applied in several real situations. Despite the necessary approximations and simplifying hypotheses, the velocity values calculated for each layer are consistent with direct information and with cross-validations obtained considering profiles acquired using different antennas and various path directions. Tests of the method on synthetic and real data sets show that the errors in the calculated velocity fields are quite low and comparable with more demanding velocity analysis techniques. The obtained EM velocity field is crucial in many processing steps, such as, for example, true amplitude recovery, depth conversion and imaging, and provide essential information to characterize the subsurface materials

    4-D quantitative GPR analyses to study the summer mass balance of a glacier: A case history

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    In order to assess the seasonal changes of the topography, the inner structure and the physical properties of a small glacier in the Eastern Alps, we performed a 4-D multi frequency GPR survey by repeating the same data acquisition in four different periods of the year 2013. The usual glacier mass balance estimation encompasses only topographic variations, but the real evolution is much more complex and includes surface melting and refreezing, snow metamorphism, and basal melting. We analyzed changes in both the imaged geometrical morphological structures and the densities, estimated from GPR data inversion. The inversion algorithm uses reflection amplitudes and traveltimes to extract the electromagnetic velocities in the interpreted layers and the densities of the frozen materials through empirical relations. The obtained results have been compared and validated with direct measures like snow thickness surveys, density logs within snow pits and ablation stakes. This study demonstrates that GPR techniques are a fast and effective tool not only for glacial qualitative studies, but also for detailed glacier monitoring and accurate quantitative analyses of crucial glaciological parameters like density distribution and water runoff

    Evaluation of Internal Structure, Volume and Mass of Glacial Bodies by Integrated LiDAR and Ground Penetrating Radar Surveys: The Case Study of Canin Eastern Glacieret (Julian Alps, Italy)

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    7We propose an integrated methodology to image the internal structure, evaluate the volume and estimate the densities of different units within ice bodies, useful for more precise mass estimation of very small glaciers. The procedure encompasses light detection and ranging (LiDAR) and ground penetrating radar (GPR) common offset data. The case study is the Canin Eastern Glacieret (CEG), a very small and maritime glacier in the Eastern Alps, and one of the lowermost glaciers of the European Alps. We calculate both volumetric and mass variations of the analysed ice body by integrating GPR measurements with LiDAR surveys acquired in different years (2006 and 2011). Between 2006 and 2011, the area of the glacieret increased from 8,510 to 17,530 m2 with a gain of 9,016 m2. The observed volume increase has been estimated in 96,350 m3 (+97 %), which corresponds to a positive mass balance of 3.89 m w.e. This quite unusual finding in the present global warming behaviour is mainly due to the above-average winter accumulation (cw) in the considered period. Moreover, the winter season 2008–2009 represented an exceptional event with a cw equal to 13.38 m, the highest of the available record. Thanks to density estimation, we infer the total mass of the CEG at the time of the geophysical surveys, comparing such results with the ones obtained with available empirical equations, observing an important mass gain in the 5 years considered.noneColucci, R.R.; Forte, E.; Boccali, C.; Dossi, M.; Lanza, L.; Pipan, M.; Guglielmin, M.Colucci, R. R.; Forte, E.; Boccali, C.; Dossi, M.; Lanza, L.; Pipan, M.; Guglielmin, Maur
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