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

A Probabilistic Multiaxial Two-Scale Model for Cast Materials in High Cycle Fatigue Regime: application to marine propellers

International audienc

A new approach to characterizing and modeling the high cycle fatigue properties of cast materials based on self-heating measurements under cyclic loadings

WOSInternational audienceThe present paper proposes, a new model for high cycle fatigue of metallic cast materials (i.e., containing initial casting micro-flaws). This model is developed in a probabilistic two-scale framework taking into account the presence of a population of initial micro-flaws by an indirect approach. The proposed model not only accounts for the failure of samples under high cycle loadings, but also for the thermal effects during cycling in a unified theoretical framework. Thus, an ad hoc identification procedure, essentially based on self-heating tests under cyclic loadings, is proposed. The performance of the proposed model is estimated by comparing experimental and theoretical results in the case of classical fatigue tests on a cast copper-aluminum alloy. The results are very promising

Improvement of the Adjustable Localization Operator identification based on the confined plasticity zone shape for multiaxial elasto-plastic cyclic predictions

International audienceSimplified methods for elasto-plastic calculations are a cost and time savings solution to obtain mechanical state at the notch tip. The Adjustable Localization Operator (ALO) method has been proven to be a robust and inherently multiaxial method. This study aims to propose an alternative strategy for identifying its parameters. The principal idea is to consider the shape of the confined plastic zone in order to adapt the various parameters of the adjustable localization operator. The proposed approach has been validated on notched structures with plane strain assumption as well as on a new design structure for multiaxial proportional and non-proportional loadings. The results obtained have shown the interest of considering the shape of the confined plastic

Identification d’un modèle à deux échelles probabiliste pour la prévision de la tenue à la fatigue polycyclique à partir de mesures d’auto-échauffement sous chargements cycliques

La fatigue polycyclique est un phénomène masqué (la pièce reste élastique). Des approches à deux échelles sont donc développées pour décrire ce phénomène. Une des difficultés majeures de ces approches concernent l’identification du comportement de la phase microscopique. On propose, ici, l’utilisation de la mesure d’auto-échauffement sous chargements cycliques pour, d’une part, identifier ce comportement, et d’autre part, caractériser la population des sites où apparaît la microplasticité

Stratégie rapide de prévision de la tenue à la fatigue à grand nombre de cycles d'un alliage de fonderie : application aux matériaux pour hélices marine

108ème session de l'ATMA (communication par affiche dans un congrès national

Fast Characterization of High-Cycle Fatigue Properties of a Cast Copper-Aluminium Alloy by Self-Heating Measurements under Cyclic Loadings

International audienc

Effet du procédé de compaction isostatique à chaud sur les propriétés à la fatigue polycyclique d'un alliage cupro-aluminium de fonderie

WOSNational audiencePour améliorer la tenue mécanique à la fatigue polycyclique des matériaux de fonderie, la Compaction Isostatique à Chaud (CIC) peut être utilisée. Elle consiste en un traitement thermomécanique des pièces moulées afin de refermer, complètement ou partiellement, les défauts initiaux qu'elles contiennent. On propose ici d'utiliser des mesures d'auto-échauffement sous chargements cycliques et un modèle associé pour caractériser le gain en tenue à la fatigue apporté par le procédé CIC sur un alliage cupro-aluminium de fonderie

A probabilistic multiaxial two-scale model for cast materials in high cycle fatigue regime

International audienc

Prise en compte indirecte des défauts de fonderie dans la prévision de la tenue en fatigue d'une hélice marine

National audienc