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

The improvements of three-dimensional seismic interpretation in comparison with the two-dimensional seismic interpretation in Al-Amal oil field, Gulf of Suez, Egypt

Thirteen 2D seismic lines were interpreted with the help of well velocity and time-depth trace conversion to construct the structure-tectonic maps. This is to characterize the different stratigraphic tops of Al-Amal area, as well as to confirm the validity of the proposed structural model. Most of the available seismic data in Al-Amal area were investigated and reviewed to select the best quality set. In order to study the detailed structural elements based on the 3D seismic lines; six depth structure contour maps were constructed on the tops of Zeit, South Gharib, Belayim, Kareem, Nukhul and Matulla formations from top downward. Interpretation was aided by the missing sections detected from the available well tops and dip-meter data as well. These maps indicate that, both of Miocene and Pre-Miocene formations in Al-Amal field were affected by elongated tilted graben blocks trending in the NW–SE directions and bounded by two sets of faults, which are down throwing toward the west and eastern directions