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

Revenue Risk-Reduction Impacts of Crop Insurance in a Multicrop Framework

The authors develop a multicrop insurance model to evaluate crop insurance decisions when several crops are produced. The results suggest that the diversification effects derived from producing multiple crops can substantially alter the risk-reduction impacts of crop insurance versus if the decision is viewed from the perspective of a single crop. Further, the relatedness of crop production and price responses among crops differs considerably across insurance products and strategies. As a result, insurance strategies that might provide the maximum risk reduction for an individual crop do not necessarily carry over to the multicrop case. Copyright 2010, Oxford University Press.

Measurements of the line shape of the Z0 and determination of electroweak parameters from its hadronic and leptonic decays

During the LEP running periods in 1990 and 1991 DELPHI has accumulated approximately 450000 Z0 decays into hadrons and charged leptons. The increased event statistics coupled with improved analysis techniques and improved knowledge of the LEP beam energies permit significantly better measurements of the mass and width of the Z0 resonance. Model independent fits to the cross sections and leptonic forward-backward asymmetries yield the following Z0 parameters: the mass and total width Mz = 91.187 ± 0.009 GeV, ΓZ = 2.486 ± 0.012 GeV, the hadronic and leptonic partial widths Γhad = 1.725 ± 0.012 GeV, Γl, = 83.01 ± 0.52 MeV, the invisible width Γinv = 512 ± 10 MeV, the ratio of hadronic to leptonic partial widths Rl = 20.78 ± 0.15, and the Born level hadronic peak cross section σ0 = 40.90 ± 0.28 nb. Using these results and the value of αs determined from DELPHI data, the number of light neutrino species is determined to be 3.08 ± 0.05. The individual leptonic widths are found to be: Γe = 82.93 ± 0.70 MeV, Γμ = 83.20 ± 1.11 MeV and Γτ = 82.89 ± 1.31 MeV. Using the measured leptonic forward-backward asymmetries and assuming lepton universality, the squared vector and axial-vector couplings of the Z0 to charged leptons are found to be gvl 2 = (1.47 ± 0.51) × 10-3 and gAl 2 = 0.2483 ± 0.0016. A full Standard Model fit to the data yields a value of the top mass mt = 115-82 +52(expt.)-24 +23(Higgs) GeV, corresponding to a value of the weak mixing angle sin2 θeff lept = 0.2339±0.0015(expt.)-0.0004 +0.0001(Higgs). Values are obtained for the variables S and T, or ∈1 and ∈3 which parameterize electroweak loop effects.0SCOPUS: ar.jinfo:eu-repo/semantics/publishe