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

The 27 February 2010 Maule, Chile tsunami: initial height and propagation from uniform and non-uniform fault slip models

2273-2285The 27 February 2010 Maule (Chile) tsunami was numerically modeled using the SWAN (Simulating WAves Near-Shore) code which solves the non-linear long wave equations of fluid flow by a finite difference algorithm. The computational area is divided into two computational domains with a grid of 2 arc min and 0.5 arc min.  Bathymetry data for the domains are interpolated from the General Bathymetry Chart of the Ocean (GEBCO) 30 arc-seconds grid data. Results from uniform and non-uniform slip models are compared with available tide gauges and Deep-ocean Assessment and Reporting of Tsunami (DART) buoy records

Rheological stratification and spatial variations in the effective elastic thickness of the lithosphere underneath the central Anatolian region, Turkey

In this study, the regional components of global model EGM08 Bouguer anomalies obtained by low pass filtering were inverted to map the geometries of Moho and Lithosphere-Asthenosphere Boundary (LAB) of the central Anatolian region. It was determined the Moho and LAB depths in the region to be 35.8-41.2 km and 67-91 km, respectively. The results from rheological modeling indicate mechanical decoupling of the crust and uppermost lithospheric mantle in eastern part and coupling in the western part of the study area. We also compare the Theological stratification with the focal depth distribution of earthquakes to examine the possible discrepancies between the brittle-ductile transition zone and the maximum depths of earthquakes along the selected profiles. The spatial variations of effective elastic thicknesses (EET) of the lithosphere have been estimated from the strength of the crust and lithospheric mantle by implying deformation gradient at Moho and LAB. The EET values vary in the range of 19-24.3 km. Although the EET values are relatively high in the eastern part of the region, lower EET values are directly underlain by thinned lithosphere of northwestern and southwestern part of central Anatolian region. We also analyze the crustal rheologies obtained from the lithospheric strength by delineating the pattern of crustal seismic activities

The 30 October 2020 (11:51 UTC) Izmir-Samos Earthquake and Tsunami; Post-Tsunami Field Survey Preliminary Results

A strong earthquake (Mw=6.6 AFAD*, Mw=6.9** KOERI, Mw=7.0 USGS***) of normal faulting striking about E-W occurred on October 30, 2020 (11:51 UTC) in between offshore Seferihisar (Izmir, Turkey) and Samos Island (Greece). The earthquake generated a tsunami that affected an area in the Aegean Coast of Turkey from Cesme Alacati in the northwestern part to Gumuldur coast in the southeastern part. Immediately after the event, a post-event field survey was performed on 31 October and 1 November 2020 by a team of seven people (A.C. Yalciner, G.G. Dogan, E. Ulutas and O. Polat, A. Tarih, E. R. Yapar and E. Yavuz) from METU, Kocaeli University, Dokuz Eylul University and Istanbul Metropolitan Municipality. The Turkey coast survey area covers mainly three parts: i) Alacati and Zeytineli regions in the Northwestern, ii) Sigacik Bay and Akarca region in Seferihisar coast in the North, and iii) Tepecik and Gumuldur regions in the Northeastern with respect to the earthquake epicenter. The team feels deep sorrow and express their condolences to the people for the loss of life and property in Izmir, Turkey and Greece.Unfortunately, the tsunami was not recorded by any tide gauge located along the Turkish Coast of the Aegean Sea. Therefore, findings from the post-event survey have gained much more importance as the main documentation of sea level variations. The main objectives of this survey are to document the tsunami effects along the coast, obtain any available data on the observed coastal amplitudes and inundation extent, take pictures and audiovisual recording before they were cleaned, interview the eyewitnesses and to understand and explain the event in detail.According to the findings in this field survey and eyewitness reports, the most impacted areas were Sigacik Marina, Sigacik Bay and Akarca region located in a 30 km distance to the epicenter in the northern direction. The maximum inundation distance reached 320 m in Akarca, where 20 boats were sunk in a small fishery port, as reported by the head of the port. The flow depth at this location was measured as 1.86 m. There was a splash height of 1.9 m recorded on a vertical wall of a highly damaged house just near the shore. The more to the southeastern coast after Akarca region, the less impacts were observed. There was almost no significant inundation water motion after Gumuldur. The tsunami impacts highly decreased after the cape of v shape peninsula between Tepecik and Gumuldur.In the northeastern part, Alacati and Zeytineli, the maximum inundation was observed along Alacati Azmak measured as 1300 m. The maximum runup was measured as 1.9 m on the palm trees 50 m away from the coastline in Zeytineli region.To summarize, our findings show that in small bays with narrow entrances, the tsunami was much amplified and the impacts on these coast were more severe. The region contains many streams (called Azmak in the local language) in the bays, which increases the potential of tsunami inundation and damage as also experienced in this event. Another important point is the remarkable increase in the awareness of the people who mostly moved away from the shore after noticing the sea withdrawal. However, unfortunately, a victim, who could not resist the strong current generated and died, was reported. After the 2017 Bodrum-Kos tsunami, the Aegean Sea with its high seismic mobility and this event once more reminded considerable tsunami potential in the eastern Mediterranean.</p

The 30 October 2020 Aegean Sea Tsunami: Post-Event Field Survey Along Turkish Coast

On 30 October 2020, a strong normal-faulting earthquake struck Samos Island in Greece and Izmir Province in Turkey, both in the eastern Aegean Sea. The earthquake generated a tsunami that hit the coasts of Samos Island, Greece and Izmir, Turkey. National teams performed two post-tsunami field surveys on 31 October to 1 November 2020, and 4-6 November 2020, along the Turkish coastline; while the former was a quick survey on the days following the tsunami, the latter involved more detailed measurement and investigation focusing on a similar to 110-km-long coastline extending from Alacati (cesme District of Izmir) to Gumuldur (Menderes District of Izmir). The survey teams measured runup and tsunami heights, flow depths, and inundation distances at more than 120 points at eight different localities. The largest tsunami runup among the surveyed locations was measured as 3.8 m in Akarca at a distance of 91 m from the shoreline. The maximum tsunami height of 2.3 m (with a flow depth of 1.4 m) was observed at Kaleici region in Sigacik, where the most severe tsunami damage was observed. There, the maximum runup height was measured as 1.9 m at the northeastern side of the bay. The survey team also investigated tsunami damage to coastal structures, noticing a gradual decrease in the impact from Gumuldur to further southeast. The findings of this field survey provide insights into the coastal impact of local tsunamis in the Aegean Sea