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

Impact of beam far side-lobe knowledge in the presence of foregrounds for LiteBIRD

International audienceWe present a study of the impact of an uncertainty in the beam far side-lobe knowledge on the measurement of the Cosmic Microwave Background $B$-mode signal at large scale. It is expected to be one of the main source of systematic effects in future CMB observations. Because it is crucial for all-sky survey missions to take into account the interplays between beam systematic effects and all the data analysis steps, the primary goal of this paper is to provide the methodology to carry out the end-to-end study of their effect for a space-borne CMB polarization experiment, up to the cosmological results in the form of a bias $\delta r$ on the tensor-to-scalar ratio $r$. LiteBIRD is dedicated to target the measurement of CMB primordial $B$ modes by reaching a sensitivity of $\sigma \left( r \right) \leq 10^{-3}$ assuming $r=0$. As a demonstration of our framework, we derive the relationship between the knowledge of the beam far side-lobes and the tentatively allocated error budget under given assumptions on design, simulation and component separation method. We assume no mitigation of the far side-lobes effect at any stage of the analysis pipeline. We show that $\delta r$ is mostly due to the integrated fractional power difference between the estimated beams and the true beams in the far side-lobes region, with little dependence on the actual shape of the beams, for low enough $\delta r$. Under our set of assumptions, in particular considering the specific foreground cleaning method we used, we find that the integrated fractional power in the far side-lobes should be known at a level as tight as $\sim 10^{-4}$, to achieve the required limit on the bias $\delta r < 1.9 \times 10^{-5}$. The framework and tools developed for this study can be easily adapted to provide requirements under different design, data analysis frameworks and for other future space-borne experiments beyond LiteBIRD

Impact of beam far side-lobe knowledge in the presence of foregrounds for LiteBIRD

International audienceWe present a study of the impact of an uncertainty in the beam far side-lobe knowledge on the measurement of the Cosmic Microwave Background $B$-mode signal at large scale. It is expected to be one of the main source of systematic effects in future CMB observations. Because it is crucial for all-sky survey missions to take into account the interplays between beam systematic effects and all the data analysis steps, the primary goal of this paper is to provide the methodology to carry out the end-to-end study of their effect for a space-borne CMB polarization experiment, up to the cosmological results in the form of a bias $\delta r$ on the tensor-to-scalar ratio $r$. LiteBIRD is dedicated to target the measurement of CMB primordial $B$ modes by reaching a sensitivity of $\sigma \left( r \right) \leq 10^{-3}$ assuming $r=0$. As a demonstration of our framework, we derive the relationship between the knowledge of the beam far side-lobes and the tentatively allocated error budget under given assumptions on design, simulation and component separation method. We assume no mitigation of the far side-lobes effect at any stage of the analysis pipeline. We show that $\delta r$ is mostly due to the integrated fractional power difference between the estimated beams and the true beams in the far side-lobes region, with little dependence on the actual shape of the beams, for low enough $\delta r$. Under our set of assumptions, in particular considering the specific foreground cleaning method we used, we find that the integrated fractional power in the far side-lobes should be known at a level as tight as $\sim 10^{-4}$, to achieve the required limit on the bias $\delta r < 1.9 \times 10^{-5}$. The framework and tools developed for this study can be easily adapted to provide requirements under different design, data analysis frameworks and for other future space-borne experiments beyond LiteBIRD

LiteBIRD Science Goals and Forecasts. A Case Study of the Origin of Primordial Gravitational Waves using Large-Scale CMB Polarization

International audienceWe study the possibility of using the $LiteBIRD$ satellite $B$-mode survey to constrain models of inflation producing specific features in CMB angular power spectra. We explore a particular model example, i.e. spectator axion-SU(2) gauge field inflation. This model can source parity-violating gravitational waves from the amplification of gauge field fluctuations driven by a pseudoscalar "axionlike" field, rolling for a few e-folds during inflation. The sourced gravitational waves can exceed the vacuum contribution at reionization bump scales by about an order of magnitude and can be comparable to the vacuum contribution at recombination bump scales. We argue that a satellite mission with full sky coverage and access to the reionization bump scales is necessary to understand the origin of the primordial gravitational wave signal and distinguish among two production mechanisms: quantum vacuum fluctuations of spacetime and matter sources during inflation. We present the expected constraints on model parameters from $LiteBIRD$ satellite simulations, which complement and expand previous studies in the literature. We find that $LiteBIRD$ will be able to exclude with high significance standard single-field slow-roll models, such as the Starobinsky model, if the true model is the axion-SU(2) model with a feature at CMB scales. We further investigate the possibility of using the parity-violating signature of the model, such as the $TB$ and $EB$ angular power spectra, to disentangle it from the standard single-field slow-roll scenario. We find that most of the discriminating power of $LiteBIRD$ will reside in $BB$ angular power spectra rather than in $TB$ and $EB$ correlations

LiteBIRD Science Goals and Forecasts. A Case Study of the Origin of Primordial Gravitational Waves using Large-Scale CMB Polarization

International audienceWe study the possibility of using the $LiteBIRD$ satellite $B$-mode survey to constrain models of inflation producing specific features in CMB angular power spectra. We explore a particular model example, i.e. spectator axion-SU(2) gauge field inflation. This model can source parity-violating gravitational waves from the amplification of gauge field fluctuations driven by a pseudoscalar "axionlike" field, rolling for a few e-folds during inflation. The sourced gravitational waves can exceed the vacuum contribution at reionization bump scales by about an order of magnitude and can be comparable to the vacuum contribution at recombination bump scales. We argue that a satellite mission with full sky coverage and access to the reionization bump scales is necessary to understand the origin of the primordial gravitational wave signal and distinguish among two production mechanisms: quantum vacuum fluctuations of spacetime and matter sources during inflation. We present the expected constraints on model parameters from $LiteBIRD$ satellite simulations, which complement and expand previous studies in the literature. We find that $LiteBIRD$ will be able to exclude with high significance standard single-field slow-roll models, such as the Starobinsky model, if the true model is the axion-SU(2) model with a feature at CMB scales. We further investigate the possibility of using the parity-violating signature of the model, such as the $TB$ and $EB$ angular power spectra, to disentangle it from the standard single-field slow-roll scenario. We find that most of the discriminating power of $LiteBIRD$ will reside in $BB$ angular power spectra rather than in $TB$ and $EB$ correlations

Impact of beam far side-lobe knowledge in the presence of foregrounds for LiteBIRD

International audienceWe present a study of the impact of an uncertainty in the beam far side-lobe knowledge on the measurement of the Cosmic Microwave Background $B$-mode signal at large scale. It is expected to be one of the main source of systematic effects in future CMB observations. Because it is crucial for all-sky survey missions to take into account the interplays between beam systematic effects and all the data analysis steps, the primary goal of this paper is to provide the methodology to carry out the end-to-end study of their effect for a space-borne CMB polarization experiment, up to the cosmological results in the form of a bias $\delta r$ on the tensor-to-scalar ratio $r$. LiteBIRD is dedicated to target the measurement of CMB primordial $B$ modes by reaching a sensitivity of $\sigma \left( r \right) \leq 10^{-3}$ assuming $r=0$. As a demonstration of our framework, we derive the relationship between the knowledge of the beam far side-lobes and the tentatively allocated error budget under given assumptions on design, simulation and component separation method. We assume no mitigation of the far side-lobes effect at any stage of the analysis pipeline. We show that $\delta r$ is mostly due to the integrated fractional power difference between the estimated beams and the true beams in the far side-lobes region, with little dependence on the actual shape of the beams, for low enough $\delta r$. Under our set of assumptions, in particular considering the specific foreground cleaning method we used, we find that the integrated fractional power in the far side-lobes should be known at a level as tight as $\sim 10^{-4}$, to achieve the required limit on the bias $\delta r < 1.9 \times 10^{-5}$. The framework and tools developed for this study can be easily adapted to provide requirements under different design, data analysis frameworks and for other future space-borne experiments beyond LiteBIRD

LiteBIRD science goals and forecasts. A case study of the origin of primordial gravitational waves using large-scale CMB polarization

We study the possibility of using the LiteBIRD satellite B-mode survey to constrain models of inflation producing specific features in CMB angular power spectra. We explore a particular model example, i.e. spectator axion-SU(2) gauge field inflation. This model can source parity-violating gravitational waves from the amplification of gauge field fluctuations driven by a pseudoscalar "axionlike" field, rolling for a few e-folds during inflation. The sourced gravitational waves can exceed the vacuum contribution at reionization bump scales by about an order of magnitude and can be comparable to the vacuum contribution at recombination bump scales. We argue that a satellite mission with full sky coverage and access to the reionization bump scales is necessary to understand the origin of the primordial gravitational wave signal and distinguish among two production mechanisms: quantum vacuum fluctuations of spacetime and matter sources during inflation. We present the expected constraints on model parameters from LiteBIRD satellite simulations, which complement and expand previous studies in the literature. We find that LiteBIRD will be able to exclude with high significance standard single-field slow-roll models, such as the Starobinsky model, if the true model is the axion-SU(2) model with a feature at CMB scales. We further investigate the possibility of using the parity-violating signature of the model, such as the TB and EB angular power spectra, to disentangle it from the standard single-field slow-roll scenario. We find that most of the discriminating power of LiteBIRD will reside in BB angular power spectra rather than in TB and EB correlations

LiteBIRD Science Goals and Forecasts. A Case Study of the Origin of Primordial Gravitational Waves using Large-Scale CMB Polarization

International audienceWe study the possibility of using the $LiteBIRD$ satellite $B$-mode survey to constrain models of inflation producing specific features in CMB angular power spectra. We explore a particular model example, i.e. spectator axion-SU(2) gauge field inflation. This model can source parity-violating gravitational waves from the amplification of gauge field fluctuations driven by a pseudoscalar "axionlike" field, rolling for a few e-folds during inflation. The sourced gravitational waves can exceed the vacuum contribution at reionization bump scales by about an order of magnitude and can be comparable to the vacuum contribution at recombination bump scales. We argue that a satellite mission with full sky coverage and access to the reionization bump scales is necessary to understand the origin of the primordial gravitational wave signal and distinguish among two production mechanisms: quantum vacuum fluctuations of spacetime and matter sources during inflation. We present the expected constraints on model parameters from $LiteBIRD$ satellite simulations, which complement and expand previous studies in the literature. We find that $LiteBIRD$ will be able to exclude with high significance standard single-field slow-roll models, such as the Starobinsky model, if the true model is the axion-SU(2) model with a feature at CMB scales. We further investigate the possibility of using the parity-violating signature of the model, such as the $TB$ and $EB$ angular power spectra, to disentangle it from the standard single-field slow-roll scenario. We find that most of the discriminating power of $LiteBIRD$ will reside in $BB$ angular power spectra rather than in $TB$ and $EB$ correlations

Impact of beam far side-lobe knowledge in the presence of foregrounds for LiteBIRD

International audienceWe present a study of the impact of an uncertainty in the beam far side-lobe knowledge on the measurement of the Cosmic Microwave Background $B$-mode signal at large scale. It is expected to be one of the main source of systematic effects in future CMB observations. Because it is crucial for all-sky survey missions to take into account the interplays between beam systematic effects and all the data analysis steps, the primary goal of this paper is to provide the methodology to carry out the end-to-end study of their effect for a space-borne CMB polarization experiment, up to the cosmological results in the form of a bias $\delta r$ on the tensor-to-scalar ratio $r$. LiteBIRD is dedicated to target the measurement of CMB primordial $B$ modes by reaching a sensitivity of $\sigma \left( r \right) \leq 10^{-3}$ assuming $r=0$. As a demonstration of our framework, we derive the relationship between the knowledge of the beam far side-lobes and the tentatively allocated error budget under given assumptions on design, simulation and component separation method. We assume no mitigation of the far side-lobes effect at any stage of the analysis pipeline. We show that $\delta r$ is mostly due to the integrated fractional power difference between the estimated beams and the true beams in the far side-lobes region, with little dependence on the actual shape of the beams, for low enough $\delta r$. Under our set of assumptions, in particular considering the specific foreground cleaning method we used, we find that the integrated fractional power in the far side-lobes should be known at a level as tight as $\sim 10^{-4}$, to achieve the required limit on the bias $\delta r < 1.9 \times 10^{-5}$. The framework and tools developed for this study can be easily adapted to provide requirements under different design, data analysis frameworks and for other future space-borne experiments beyond LiteBIRD

Impact of beam far side-lobe knowledge in the presence of foregrounds for LiteBIRD

International audienceWe present a study of the impact of an uncertainty in the beam far side-lobe knowledge on the measurement of the Cosmic Microwave Background $B$-mode signal at large scale. It is expected to be one of the main source of systematic effects in future CMB observations. Because it is crucial for all-sky survey missions to take into account the interplays between beam systematic effects and all the data analysis steps, the primary goal of this paper is to provide the methodology to carry out the end-to-end study of their effect for a space-borne CMB polarization experiment, up to the cosmological results in the form of a bias $\delta r$ on the tensor-to-scalar ratio $r$. LiteBIRD is dedicated to target the measurement of CMB primordial $B$ modes by reaching a sensitivity of $\sigma \left( r \right) \leq 10^{-3}$ assuming $r=0$. As a demonstration of our framework, we derive the relationship between the knowledge of the beam far side-lobes and the tentatively allocated error budget under given assumptions on design, simulation and component separation method. We assume no mitigation of the far side-lobes effect at any stage of the analysis pipeline. We show that $\delta r$ is mostly due to the integrated fractional power difference between the estimated beams and the true beams in the far side-lobes region, with little dependence on the actual shape of the beams, for low enough $\delta r$. Under our set of assumptions, in particular considering the specific foreground cleaning method we used, we find that the integrated fractional power in the far side-lobes should be known at a level as tight as $\sim 10^{-4}$, to achieve the required limit on the bias $\delta r < 1.9 \times 10^{-5}$. The framework and tools developed for this study can be easily adapted to provide requirements under different design, data analysis frameworks and for other future space-borne experiments beyond LiteBIRD