Adición de arcilla calcinada al concreto estructural para mejorar propiedades físicas del concreto F’C =2 80 y 350 kg/cm2, en la provincia de Puno - 2021

El objetivo general de la presente investigación es determinar la influencia de la arcilla calcinada en las propiedades físicas del concreto f'c =280 y f'c =350 kg/cm2 para su uso estructural, ya que en la región de Puno los concretos de alta resistencia son de difícil obtención, además, el costo para obtener altas resistencias es muy elevado. Por estos motivos, es necesario proponer alternativas que mejoren las propiedades físicas del concreto y reduzcan la inversión económica. En ese sentido, se tiene el propósito de plantear el uso de la arcilla calcinada, siendo este un insumo de bajo costo y analizar la influencia de esta en las propiedades físicas de concretos de resistencias f'c =280 y f'c =350 kg/cm2. El método de la investigación es Hipotético – Deductivo, ya que se manipuló la variable independiente arcilla calcinada en incrementos progresivos (6 %, 12 % y 18 %) hasta observar los cambios que se presentan en la consistencia y resistencia del concreto f'c =280 y f'c =350 kg/cm2. Se concluyó que la arcilla calcinada sí mejora significativamente las propiedades físicas del concreto f'c =280 y f'c =350 kg/cm2 para su uso estructural, así mismo, que el porcentaje óptimo de arcilla calcinada utilizada como adición al concreto estructural que mejora las propiedades físicas del concreto f'c =280 y f'c =350 kg/cm2 es el 6 %

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