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

Performance investigations on data protection algorithms in generalized multi protocol label switched optical networks

Abstract In future generation networks, data protection is a crucial necessity particularly when information is sent on a system. Network protection has three objectives known as discretion, reliability and accessibility. The most common procedure exploited to attain this ambition is encryption. The Generalized Multi Protocol Label Switched (GMPLS) optical networks are designed to survive Internet Protocol’s (IPʹs) unreliable delivery. In this paper, GMPLS network is proposed with random users and then the data protection algorithms have been analyzed on proposed GMPLS optical network. The various algorithms involve Rivest Shamir Adleman (RSA) algorithm and Advanced Encryption Standard (AES) algorithm. The considered algorithms are very popular but have not been implemented on GMPLS optical networks in the literature which shows the novelty of the presented work. The network performance is compared for these algorithms in terms of various parameters like blocking probability and latency. The results reveal that RSA reduces the blocking probability < 0.005 and latency < 0.007 ms. This shows that RSA gives better performance than AES algorithm and enhance the quality of service considering blocking probability, latency and overheads in GMPLS optical networks leading to enhanced data protection