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

Modelo unificado de propagación de oleaje e hidrodinámica no lineal

Modelo unificado de propagación de oleaje e hidrodinámica no linea

Aprovechamiento de la energía de las corrientes con el Hidrogenerador IMPULSA

En este trabajo se presentan las particularidades del proceso de diseño y los resultados de las primeras pruebas de un hidrogenerador para aprovechamiento de las corrientes marinas. El dispositivo, nombrado IMPULSA, es precisamente una turbina flotante de eje vertical y flujo conducido, cuyo desarrollo ha superado ya las etapas de conceptualización (con base en trabajos previos), construcción de modelos y pruebas de funcionamiento iniciales. El diseño geométrico de la carcasa que alberga los rotores se probó en una instalación experimental; de estos ensayos se obtuvieron los coeficientes de empuje y sustentación para calibrar y caracterizar el flujo a través del hidrogenerador con simulación numérica, utilizando la herramienta computacional PHOENICS con la que, a su vez, se verificó el funcionamiento óptimo de dicha carcasa. Un segundo grupo de ensayos, llevados a cabo en un canal de riego, mostró la conveniencia de utilizar un rotor helicoidal tipo Savonius de cuatro álabes, ya que permite aprovechar condiciones de velocidad relativamente bajas en el fluido. Los resultados del modelo numérico coinciden con los registros experimentales, en que la construcción del dispositivo es viable en lugares con velocidades de corriente superiores a 1 m/s

Experimental Investigation of the Hydrodynamic Performance of Land-Fixed Nearshore and Onshore Oscillating Water Column Systems with a Thick Front Wall

Most experimental research on land-fixed Oscillating Water Column (OWC) systems assume that the OWC-water wave interaction happens with waves that propagate normally towards the device. However, the angle of incidence of the waves can determine the performance of the OWC, in particular the wave period at which the device resonates. In this study, an experimental investigation to examine the interaction of regular, oblique, water waves with a land-fixed, thick-front wall OWC device in terms of its hydrodynamic performance is reported. A 1:20 Froude scale was used to replicate a single chamber of the Mutriku Wave Energy Plant (MWEP), and a series of tests were carried out in a spectral wave basin. The goal of this study is to look at how incident wave direction and device location affect the hydrodynamic performance of land-fixed OWC systems in regular wave conditions with varying wave heights. The hydraulic performance includes the assessment of the wave amplification factor, hydrodynamic efficiency, the non-dimensional air pressure inside the chamber and non-dimensional water pressures on the chamber walls. The findings show that, for the nearshore OWC device, the period at which resonance occurs decreases when the incident wave angle increases. For the corresponding wave angles, similar results were found for the onshore and nearshore OWC devices, with a slight frequency shift in the bandwidth of the hydrodynamic efficiency. Furthermore, it was found that when wave height increases, the hydrodynamic efficiency improves for both short and long wave periods, with the exception of the resonance period, where the trend is reversed. Finally, regardless of the location, an OWC device with a thick front wall performs well when interacting with intermediate and long-period waves

Experimental Investigation of the Hydrodynamic Performance of Land-Fixed Nearshore and Onshore Oscillating Water Column Systems with a Thick Front Wall

Most experimental research on land-fixed Oscillating Water Column (OWC) systems assume that the OWC-water wave interaction happens with waves that propagate normally towards the device. However, the angle of incidence of the waves can determine the performance of the OWC, in particular the wave period at which the device resonates. In this study, an experimental investigation to examine the interaction of regular, oblique, water waves with a land-fixed, thick-front wall OWC device in terms of its hydrodynamic performance is reported. A 1:20 Froude scale was used to replicate a single chamber of the Mutriku Wave Energy Plant (MWEP), and a series of tests were carried out in a spectral wave basin. The goal of this study is to look at how incident wave direction and device location affect the hydrodynamic performance of land-fixed OWC systems in regular wave conditions with varying wave heights. The hydraulic performance includes the assessment of the wave amplification factor, hydrodynamic efficiency, the non-dimensional air pressure inside the chamber and non-dimensional water pressures on the chamber walls. The findings show that, for the nearshore OWC device, the period at which resonance occurs decreases when the incident wave angle increases. For the corresponding wave angles, similar results were found for the onshore and nearshore OWC devices, with a slight frequency shift in the bandwidth of the hydrodynamic efficiency. Furthermore, it was found that when wave height increases, the hydrodynamic efficiency improves for both short and long wave periods, with the exception of the resonance period, where the trend is reversed. Finally, regardless of the location, an OWC device with a thick front wall performs well when interacting with intermediate and long-period waves