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

Hall and ohmic heating effects on radiative flow of viscoelastic nanofluids over a convective rotating rigid/stretched disk

In this article, the impacts of the Hall current on the 3D forced convection and heat transfer due to the rotation of a disk are examined. The disk's surface is considered to be rigid or stretched and the non-Newtonian viscoelastic nanofluids are assumed to be the working suspension. The convective boundary conditions together with passively control of the nanoparticles are imposed to the disk's surface. Several important influences are considered such as Ohmic heating, thermal radiation, heat generation/absorption and Arrhenius energy. The transformed governing equations are solved numerically using the shooting technique with 4th order Runge-Kutta method. The major findings revealed that the Hall current parameter enhances the radial velocity in both rigid and stretched surface while the tangential velocity has lower features. Also, the viscoelastic nanofluid parameter causes lower behaviors of tangential velocity and nanofluid temperatures. The considered range of the Hall parameter causes an increase in the heat transfer rate by 1.73%