The role of open abdomen in non-trauma patient : WSES Consensus Paper

The open abdomen (OA) is defined as intentional decision to leave the fascial edges of the abdomen un-approximated after laparotomy (laparostomy). The abdominal contents are potentially exposed and therefore must be protected with a temporary coverage, which is referred to as temporal abdominal closure (TAC). OA use remains widely debated with many specific details deserving detailed assessment and clarification. To date, in patients with intra-abdominal emergencies, the OA has not been formally endorsed for routine utilization; although, utilization is seemingly increasing. Therefore, the World Society of Emergency Surgery (WSES), Abdominal Compartment Society (WSACS) and the Donegal Research Academy united a worldwide group of experts in an international consensus conference to review and thereafter propose the basis for evidence-directed utilization of OA management in non-trauma emergency surgery and critically ill patients. In addition to utilization recommendations, questions with insufficient evidence urgently requiring future study were identified.Peer reviewe

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

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

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

Phase transitions of BaTi0.9Rh0.1O3±δ perovskite-type oxides under reducing environments

Perovskite-type oxides of composition BaTi0.9Rh0.1O3±δ were prepared following a new chemical route that avoids the formation of hydroxyl species and precipitation, and allows the homogeneous distribution of Rh in the final mixed metal oxide. The high dispersion of Rh and the formation of the solid solution between Rh and the BaTiO3 perovskite is confirmed by means of X-ray diffraction (XRD) and extended X-ray absorption fine structure spectroscopy (EXAFS). The presence of Rh stabilized the hexagonal BaTi0.9Rh0.1O3±δ phase, which decomposes into barium orthotitanate (BaTi2O4) and metallic Rh° in reducing environment. This phase transition starts already at 700 °C and is only partially completed at 900 °C suggesting that part of the Rh present in the perovskite lattice might not be easily reduced by hydrogen. These aspects and further open questions are discussed

Interfacial insight in multi-junction metal oxide photoanodes for water-splitting applications

Photoelectrochemical (PEC) properties of nanostructured hematite (Fe2O3) thin films prepared using plasma-enhanced chemical vapor deposition (PE-CVD) were investigated against the influence of processing parameters and post-synthesis heat-treatment procedures.Annealing at high temperatures (> 500 \ub0C) was found to substantially affect the micro-structure (grain growth and densification) and electronic (interdiffusion at the film/substrate interface) concomitantly manifested in an enhancement in the PEC behavior. The Sn impuritylevel in hematite films was found to increase with the annealing temperature with highest values achieved in samples heat-treated at 750 \ub0C, due to the interdiffusion and substitution of Sn(IV) species at Fe(III) sites. Sn:Fe2O3 films exhibited significantly high photocurrent density of 1.33 mAcm-2 at the water oxidation level of 1.23V vs. RHE. The diffusion of Sn ions into iron oxide lattice altered the electronic properties of hematite films duetoelectron\u2013donor behavior of the dopants that was verified by X-ray photoelectron spectroscopy and secondary ion mass spectroscopy (SIMS) analyses.Deposition of a thin overlayer of TiO2 (10 nm) on hematite films by atomic layer deposition (ALD) was found to furthe rimprove the photocurrent density to 1.8 mAcm-2 at 1.23V vs.RHE. Ab-initio calculations on the effect of substitutional Sn(IV) dopants in the Fe2O3 lattice on the electronic structure and the band alignment between hematite and theTiO2 over layer revealed that Sn-dopants led to the generation of localized Fe (II) centers augmenting then-type behavior of hematite.No effect of the Sn-dopingonthe electrostatic potential was found on a macroscopic scale.However, the charge transfer from the Sn-doping to the Fe(II) centers would cause high electric fields on the nanometer scale and might hence play an important role in the efficient separation o felectron and holes.The simulations showed that the hematite band edges are enclosed by the TiO2 band edges and therefore electron depletion at the surface\u2013liquid interface is enhanced.This might lead to reduced recombination rates near the surface and consequently to increased photocurrents, since the Fe2O3/TiO2 interface constitutes a barrier for hole transport