Environmental sustainability in intensive care: the path forward. An ESICM Green Paper.

PURPOSE: The European Society of Intensive Care Medicine (ESICM) Green Paper aims to address the challenge of environmental sustainability in intensive care and proposes actionable strategies for integrating sustainability into intensive care unit (ICU) stakeholder actions. METHODS: The ESICM Executive Committee appointed a task force of topic experts and ESICM committee representatives to develop the ESICM Green Paper. The task force convened biweekly from January to June 2024, identifying key domains for environmental sustainability and prioritizing actions. Drafts were iteratively refined and approved by the ESICM Executive Committee. RESULTS: Climate change will impact activities in intensive care in many ways, but also the impact of ICU activities on the environment is considerable; drivers for this include extensive resource use and waste generation in ICUs from energy consumption, use of disposable items, and advanced therapies for critically ill patients. The ESICM Green Paper outlines a structured approach for ICUs to reduce their environmental impact, emphasizing energy efficiency, waste reduction, and sustainable procurement. Furthermore, it endorses the need for awareness and education among healthcare professionals, integration of sustainability into research, and sustainable policies within scientific societies. CONCLUSIONS: The ESICM Green Paper reviewed the relevance of climate change to intensive care and provided suggestions for clinical practice, research, education, and ESICM organizational domains. It underscores that reducing intensive care's ecological footprint can coexist with high-quality patient care. Promoting a resilient, responsible healthcare system is a joint responsibility of all ICU stakeholders.

Development of the Local Food Systems Policy Index (Local Food-EPI+) tool and assessment process to benchmark the implementation of local government policies for creating healthy, equitable and environmentally sustainable food systems.

OBJECTIVE: Local governments have an important role to play in creating healthy, equitable and environmentally sustainable food systems. This study aimed to develop and pilot a tool and process for local governments in Australia to benchmark their policies for creating healthy, equitable and environmentally sustainable food systems. DESIGN: The Healthy Food Environment Policy Index (Food-EPI), developed in 2013 for national governments, was tailored to develop the Local Food Systems Policy Index (Local Food-EPI+) tool for local governments. To incorporate environmental sustainability and the local government context, this process involved a literature review and collaboration with an international and domestic expert advisory committee (n 35) and local government officials. SETTING: Local governments. RESULTS: The tool consists of sixty-one indicators across ten food policy domains (weighted based on relative importance): leadership; governance; funding and resources; monitoring and intelligence; food production and supply chain; food promotion; food provision and retail in public facilities and spaces; supermarkets and food sources in the community; food waste reuse, redistribution and reduction; and support for communities. Pilot implementation of the tool in one local government demonstrated that the assessment process was feasible and likely to be helpful in guiding policy implementation. CONCLUSION: The Local Food-EPI+ tool and assessment process offer a comprehensive mechanism to assist local governments in benchmarking their actions to improve the healthiness, equity and environmental sustainability of food systems and prioritise action areas. Broad use of this tool will identify and promote leading practices, increase accountability for action and build capacity and collaborations.

Sulfur-functionalized biochar: Synthesis, characterization, and utilization for contaminated soil and water remediation-a review.

The development of innovative, eco-friendly, and cost-effective adsorbents is crucial for addressing the widespread issue of organic and inorganic pollutants in soil and water. Recent advancements in sulfur reagents-based materials, such as FeS, MoS2, MnS, S0, CS2, Na2S, Na2S2O32-, H2S, S-nZVI, and sulfidated Fe0, have shown potential in enhancing the functional properties and elemental composition of biochar for pollutant removal. This review explores the synthesis and characterization of sulfur reagents/species functionalized biochar (S-biochar), focusing on factors like waste biomass attributes, pyrolysis conditions, reagent adjustments, and experimental parameters. S-biochar is enriched with unique sulfur functional groups (e.g., C-S, -C-S-C, C=S, thiophene, sulfone, sulfate, sulfide, sulfite, elemental S) and various active sites (Fe, Mn, Mo, C, OH, H), which significantly enhance its adsorption efficiency for both organic pollutants (e.g., dyes, antibiotics) and inorganic pollutants (e.g., metal and metalloid ions). The literature analysis reveals that the choice of feedstock, influenced by its lignocellulosic content and xylem structure, critically impacts the effectiveness of pollutant removal in soil and water. Pyrolysis parameters, including temperature (200-600 °C), duration (2-10 h), carbon-to-hydrogen (C:H) and oxygen-to-hydrogen (O:H) ratios in biochar, as well as the biochar-to-sulfur reagent modification ratio, play key roles in determining adsorption performance. Additionally, solution pH (2-8) and temperature (288, 298, and 308 K) affect the efficiency of pollutant removal, though optimal dosages for adsorbents remain inconsistent. The primary removal mechanisms involve physisorption and chemisorption, encompassing adsorption, reduction, degradation, surface complexation, ion exchange, electrostatic interactions, π-π interactions, and hydrogen bonding. This review highlights the need for further research to optimize synthesis protocols and to better understand the long-term stability and optimal dosage of S-biochar for practical environmental applications.

Enzymatic Degradation toward Herbicides: The Case of the Sulfonylureas.

Commercial herbicides, particularly sulfonylureas, are used worldwide and pose a significant challenge to environmental sustainability. The efficient degradation of sulfonylurea herbicides is critical. SulE, an esterase isolated from the bacterial strain Hansschlegelia zhihuaiae S113, shows degradation activity toward sulfonylurea herbicides. However, the detailed catalytic mechanism remains vague to a large extent. Herein, we decipher the SulEP44R-catalyzed degradation mechanism of sulfonylurea herbicides using hybrid quantum mechanics and molecular mechanics approaches. Our results show that the degradation of sulfonylureas catalyzed by SulEP44R involves four concerted elementary steps. The rate-determining step has an energy barrier range of 19.7-21.4 kcal·mol-1, consistent with the experimentally determined range of 16.0-18.0 kcal·mol-1. Distortion/interaction analysis demonstrates that active-site amino acids play a vital role in the enzymatic catalytic efficacy. The unique architecture of SulEP44R's active site can serve as an excellent template for designing artificial catalysts. Key structural and charge parameters affecting catalytic activity were systematically screened and identified. Based on the elucidated degradation mechanism, several new herbicides with both high herbicidal activity and biodegradability were developed with the aid of a high-throughput strategy. Our findings may advance the application of sulfonylurea herbicides within the framework of environmental sustainability.

The unique chemical and microbiological signatures of an array of bottled drinking water.

The bottled drinking water market has seen significant growth and diversification, yet the selection criteria lack scientific basis, as all must adhere to stringent health standards. Prior studies predominantly focused on chemical quality, with limited assessments of microbial quality using methods prone to underestimation. Moreover, insufficient research explores the impact of packaging materials and temperatures optimal for mesophilic growth on microbial quality. To understand the unique characteristics and justify the distinction among different types of bottled waters, a comprehensive analysis encompassing both chemical and microbiological aspects is imperative. Addressing these gaps, our study examines 19 diverse bottled water brands comprising purified, mineral, artesian, and sparkling water types from Saudi Arabia and abroad. Our findings reveal distinct chemical compositions among bottled waters, with notable variations across types. Flow cytometry analysis reveals significant differences in bacterial content among water types, with natural mineral waters having the highest concentrations and treated purified waters the lowest. Bacterial content in plastic-bottled mineral water suggests it may be higher than in glass-bottled water. Flow cytometry fingerprints highlight separate microbial communities for purified and mineral waters. Additionally, temperatures favorable for mesophilic growth reveal varying microbial responses among different types of bottled waters. Some variation is also observed in mineral water bottled in plastic versus glass, suggesting potential differences that warrant further investigation. 16S rRNA gene sequencing identifies unique microbial taxa among different mineral waters. Overall, our study underscores that all bottled waters meet health regulations. Furthermore, the combined chemical and microbial profiles may serve as authenticity indicators for distinct bottled water types. This study can serve as a basis for future research on the environmental impact of bottled water transportation, suggesting that locally produced water may offer a more sustainable option.

Critical care nurses' experiences on environmental sustainability: A qualitative content analysis.

BACKGROUND: Intensive care units (ICUs) are the primary producers of greenhouse gas emissions within hospitals, due to the use of several invasive materials. Nurses represent a large portion of the healthcare workforce and can be pivotal in promoting sustainability practices. Several international reports have suggested that nursing can help achieve the sustainable development objectives set by the United Nations. AIMS: The purpose is to explore behaviour related to environmental sustainability in intensive care nurses. STUDY DESIGN: A qualitative content analysis comprised of in-depth interviews involving 27 ICU nurses, who were each asked the same open-ended question. The transcripts collected were then analyzed and organized by a team of independently-working researchers. The analysis of the extrapolated concepts was carried out following the Neem M. (2022) method. The study is supported by a grant from the Centre of Excellence for Nursing Scholarship, Rome, July 2024. FINDINGS: The main recurring themes are as follows: (1) concepts of environmental sustainability in ICUs, (2) critical issues related to sustainable intervention in the ICUs (3) proactive environmental sustainability attitudes in ICUs. Time to know, define criticality, and improve is the conceptualization of sustainable behaviors experienced by ICU nurses. CONCLUSIONS: Taking the time to know and define the critical issues for implementing sustainable behaviours in the ICU, turned out to be the key to enforce the mindset of green nursing thinking. IMPLICATIONS TO CLINICAL PRACTICE: Sustainability behaviours need to be proposed and verified by ICU managers by creating sustainability teams and promoting a good working environment, founding the progression to green ICUs by focusing on health impact education and mindfulness.

Environmental, technological, and economic analysis of supercritical coal-fired power system.

Developing countries primarily rely on fossil-based energy sources to meet their energy demands. The use of fossil fuels has several adverse environmental repercussions that damage the biosphere both directly and indirectly. Among fossil fuels, coal brings about the heaviest environmental externalities, yet its abundance makes its use widespread, particular in countries having significant power generation deficits, such as Pakistan. This study presents an environmental, technological, and economic analysis of a supercritical coal-based power unit located in Pakistan and used for electricity generation. For environmental assessment, the CML-1A baseline method in OpenLCA software was used, and eight midpoint impact indicators were selected. The functional unit chosen was 1 MWh of generated electricity. The results indicated that the category of ozone layer depletion has the least impact, whereas global warming potential has the highest impact score. Except for photochemical oxidation and human toxicity, the plant operational stage dominated most of the selected impact categories. The current paper also reveals that the removal efficiency of CO2 and other pollutants is higher in supercritical compared to subcritical plants. Moreover, the economic feasibility of supercritical plant is compared with chemical looping combustion (CLC)-based supercritical coal-fired power plant, and results shows that CLC-based coal-fired power plant is a more competitive and environmentally friendly option. The utilization of a scientific cleaner energy-management system in real-time, as exemplified in this study, may facilitate the development of a optimal policy framework that encourages for the adoption of cleaner coal power generation in developing countries, ultimately resulting in improved energy sustainability. Furthermore, this paper also presents some policy implications which could be helpful for policymakers, researchers, and industrialists to improve the sustainability of energy in emerging economies.

The power of green: Harnessing phytoremediation to combat micro/nanoplastics.

Plastic pollution and its potential risks have been raising public concerns as a global environmental issue. Global plastic waste may double by 2030, posing a significant challenge to the remediation of environmental plastics. In addition to finding alternative products and managing plastic emission sources, effective removal technologies are crucial to mitigate the negative impact of plastic pollution. However, current remediation strategies, including physical, chemical, and biological measures, are unable to compete with the surging amounts of plastics entering the environment. This perspective lays out recent advances to propel both research and action. In this process, phytoaccumulation, phytostabilization, and phytofiltration can be applied to reduce the concentration of nanoplastics and submicron plastics in terrestrial, aquatic, and atmospheric environments, as well as to prevent the transport of microplastics from sources to sinks. Meanwhile, advocating for a more promising future still requires significant efforts in screening hyperaccumulators, coupling multiple measures, and recycling stabilized plastics from plants. Phytoremediation can be an excellent strategy to alleviate global micro/nanoplastic pollution because of the cost-effectiveness and environmental sustainability of green technologies.

Energy and environmental analysis of a condensate recovery thermal energy storage for the building cooling system.

In the pursuit of sustainability and reduced environmental impact, waste-to-energy conversion methods are gaining importance. This study investigates the untapped potential of air-conditioning (AC) condensate as a source of chilled energy in AC systems of varying cooling capacities expressed in tons of refrigeration (TR) including 10 TR, 25 TR, and 50 TR. Field assessments revealed daily condensate generation of 37-148 L at 15 ± 1 °C, indicating significant cooling potential for energy recovery. Waste coconut oil (WCO) is proposed as a phase change material (PCM) for this purpose, aiming to examine its thermal characteristics and effectiveness for energy storage. Characterization of WCO reveals a latent heat of 101 J/g and a phase transition temperature of 22.1 °C. Thermal degradation occurs between 346 and 462 °C, while stability is maintained below 60 °C. WCO exhibits solid thermal conductivity of 0.181 W/mK at 10 °C and liquid conductivity of 0.175 W/mK at 30 °C, with specific heat capacities of 1.19 J/g K (solid) and 2.43 J/g K (liquid), ensuring efficient heat transfer during phase change. A pilot experiment examines the charging and discharging dynamics of WCO. It achieves complete solidification in 160 min at a freezing temperature of 21.3 °C, with 1.1 °C supercooling. During melting at ambient conditions (32 ± 1 °C), it takes 92 min, with a melting temperature of 21.9 °C. The study extends to evaluate the reduction in environmental impact through life cycle assessment (LCA). The significant impact values such as acidification, eutrophication, ozone depletion, fossil depletion, climate change, and metal depletion are calculated using the ecoinvent database. Overall, our study underscores the promise of WCO-based energy recovery systems in advancing sustainability efforts within the realm of air conditioning.

Patient perspectives on climate friendly healthcare: an exploratory study in obstetrics and gynaecology.

OBJECTIVE: To investigate patient perspectives on climate change and climate change mitigation strategies in healthcare. METHODS: A cross-sectional survey among gynaecological patients from two Dutch outpatient clinics. Main outcomes included patients' climate-related knowledge and worry, climate friendly healthcare perspectives and willingness to opt for climate friendly treatment alternatives. Multivariable linear regression analyses were performed to explore patient characteristics associated with climate friendly healthcare perspectives. RESULTS: 274 surveys were included. Most patients (79 %) were worried about climate change. Although almost all (91 %) found it important to contribute to climate protection, patients showed hesitance regarding healthcare measures that would impinge on individual choices. 62 % was willing to opt for climate friendly treatments, but this proportion varied by medical condition. Climate-related knowledge and worry were both positively associated with climate friendly healthcare perspectives. CONCLUSION: Gynaecological patients are concerned about climate change and possess substantial self-reported climate-related knowledge. Patients vary in their support of climate action that involves individual patient care, but the majority is open to choose climate friendly treatment alternatives for certain medical conditions. PRACTICE IMPLICATIONS: This exploratory study holds implications for the feasibility of integrating climate impact into clinical decision-making and provides a foundation for normative evidence for decarbonizing healthcare.

Environmental remediation and sustainable design of iron oxide nanoparticles for removal of petroleum-derived pollutants from water: A critical review.

The global problem of major oil spills not only generates crude oil pollution, but produces many derivatives that pose ecological and human health challenges. While extensive research has focused on understanding the types of these contaminants, their transport modes, detection techniques, and ecotoxicological impacts, there are still significant research gaps in mechanisms for removal of petroleum-derived pollutants by iron oxide nanoparticles (IONPs). This work summarizes systematically the types and green synthesis of IONPs for the environmental remediation of various petroleum contaminants. We also provide comprehensive coverage of the excellent removal capacity and latest environmental remediation of IONPs-based materials (e.g., pristine, modified, or porous-supported IONPs materials) for the removal of petroleum-derived pollutants, potential interaction mechanisms (e.g., adsorption, photocatalytic oxidation, and synergistic biodegradation). A sustainable framework was highlighted in depth based on a careful assessment of the environmental impacts, associated hazards, and economic viability. Finally, the review provides an possible improvements of IONPs for petroleum-derived pollutants remediation and sustainable design on future prospect. In the current global environment of pollution reduction and carbon reduction, this information is very important for researchers to synthesize and screen suitable IONPs for the control and eradication of future petroleum-based pollutants with low environmental impact.

Advancing sustainable healthcare: a concept analysis of eco-conscious nursing practices.

BACKGROUND: As the healthcare sector grapples with its environmental footprint, the concept of Eco-conscious Nursing emerges as a pivotal framework for integrating sustainability into nursing practice. This study aims to clarify and operationalize Eco-conscious Nursing, examining its attributes, antecedents, consequences, and providing operational definitions to guide future research and practice. METHODS: Utilizing a systematic literature review across PubMed, Google Scholar, and CINAHL Ultimate, this study identifies and analyzes existing theories, frameworks, and practices related to eco-conscious nursing. Through conceptual analysis, key attributes, antecedents, and consequences of Eco-conscious Nursing are delineated, leading to the formulation of comprehensive operational definitions. RESULTS: The study reveals Eco-conscious Nursing as a multifaceted concept characterized by environmental stewardship, sustainable healthcare practices, and a commitment to reducing the ecological impact of nursing care. Operational definitions highlight the role of education, awareness, and institutional support as antecedents, with improved environmental health and sustainable healthcare outcomes as key consequences. CONCLUSION: Eco-conscious Nursing represents a crucial ethos for the nursing profession, emphasizing the necessity of sustainable practices within healthcare. The operational definitions provided serve as a foundation for embedding eco-conscious principles into nursing, addressing the urgent need for sustainability in healthcare settings. Future research should focus on the empirical application of these definitions and explore the economic and cross-cultural dimensions of eco-conscious nursing.

Life cycle environmental trade-off of decarbonising UK industrial clusters - A cradle to gate approach.

The industrial sector is a major source of greenhouse gas (GHG) emissions due to process emissions and a heavy reliance on fossil fuels for heat and power. Methods exist to produce low carbon versions of products made in industrial clusters, including hydrogen, carbon capture and storage and alternative production methods, but these could increase burdens to other areas of the environment, such as resource depletion and water scarcity. This study compares different decarbonisation pathways for ammonia, cement, methanol and steel produced in the UK, to determine whether decarbonising could result in unintended environmental consequences. To determine this, life cycle assessment was applied to compare 267 different pathways to the conventional (fossil fuel) baseline. We find that most pathways lead to GHG emission reductions (43 to 78 % on average) but would increase impacts to other areas of the environment, including metal resources and ecotoxicity (8 % to 5-fold and 19 % to 24-fold, on average respectively). This study is the first to assess decarbonisation pathways for unintended environmental impacts and is of interest to industry, policy makers and anyone modelling industrial lifecycle emissions.

Forging green Horizons: Revealing Catalysts of pro-environmental behavior in emerging market.

In recent years, environmental pollution has started to threaten global economies. The understanding of consumer behavior within the context of sustainable development has become increasingly important to deal with this growing ecological complexity. Urbanization has accelerated in Pakistan, resulting in urban consumers raising more environmental concerns and promoting eco-friendly products. These concerns have demonstrated their commitment to sustainability and pro-environmental behaviors, such as reducing waste materials (e.g., plastics) and pollutants (i.e., smoke, dust, etc.), thus supporting eco-friendly behaviors. Today, Pakistan's urban consumers are well-aware of environmental complexities. As such, environmental knowledge is the driver of consumers' pro-environmental behavior, affective commitment and social capital also compel individuals to acquire ecological knowledge to enhance consumer behavior. This research considers customers' environmental knowledge and affective commitment, both of which actively contribute to pro-environmental activity. It explores the relationship between environmental knowledge, affection commitment, social capital, and environmental behavior in Pakistan. Data was gathered from Pakistan's urban customers and analyzed using Covariance-based Structural Equation Modeling (CB-SEM). The results indicate that affective commitment and social capital have a positive and significant effect on environmental knowledge and behavior. Notably, the relationship between social capital, affective commitment, and environmental behavior is mediated by knowledge of environmental issues. Through its findings, this study fosters an understanding of environmental behavior and explains the sense of responsibility and greater commitment in individuals, which thus leads them toward sustainability.

Predicting Prayagraj's Urbanization Trajectory using CA-ANN Modelling: Population Pressures and Land Use Dynamics.

Land Use/Land Cover (LULC) dynamics provide a crucial role in the monitoring, planning, and management of resources. They also offer valuable information for developing strategies to balance conservation efforts, resolve conflicts between different land uses, and address pressures from growth. The present study focuses on the assessment of LULC dynamics, their forecasting, and their changes for Prayagraj city (including its surroundings) of India. Using long-term spatiotemporal Landsat datasets (1988-2018), we have explored the interlinkages between the change dynamics and human population pressure to explore the impact of agriculture and urbanization on the city landscape. Future growth prediction is carried out by incorporating Cellular Automaton (CA) and Artificial Neural Network (ANN) models. Six exploratory layers (viz., roads, educational institutes, railway transition, slope, river, and restricted area) are used in the learning process to determine LULC change (1997-2008) simulation. The validation of real and predicted LULC is carried out for 2018, where the correctness percentage and kappa value are found to be 90.29% and 0.87, respectively. Then, the ANN- Multilayer perceptron (MLP) and CA model are applied to predict LULC-2028 using the same trained transition probabilities. Results show that Built-land has grown highly by 10.03%, whereas Agriculture land and Forest land have significantly decreased by 13.43% and 3.03%, respectively, from 1988 to 2018. The predicted LULC of 2028 reveals that Built-land will keep growing by 2.83% during 2018-2028 at the cost of Agriculture land and Forest land, especially in northern, south-western and southern region, including city's inner sphere. United Nations' human population projection reveals that the city is expected to reach a population of 1.625 million by 2028. This indicates that tremendous pressure will be placed on land resources, particularly on agricultural, barren, and forested areas. To address this alarming scenario, it is imperative to delineate future development areas, ensuring better urban planning for the environmental sustainability and economic prosperity of Prayagraj city.

Oil spills characterization and modeling using remote sensing and geophysical techniques to protect the highly vulnerable coastal zones in Alexandria, Egypt.

Nowadays, oil spills threaten both aquatic and terrestrial environments, especially in regions with intensive oil refining and shipping activities and high environmental sensitivity, such as Alexandria city, Egypt. Oil spill characterization in coastal populous cities is particularly difficult due to large chemical/physical soil heterogeneities and saltwater intrusion, which represent a major challenges for soil remediation and restoration. Recently, the development of inversion algorithms enables electrical resistivity imaging (ERI) to perform detailed characterization of near-surface soil pollution. The study implements an interdisciplinary approach using remote sensing and an advanced time-lapse 2D-inversion scheme for detailed characterization of oil spill patterns around oil refinery sites in the Alexandria coastal zone. The implemented scheme was able to improve the depth of investigation while maintaining the shallow lateral model resolution. The findings indicate that the mapped oil spills constitute a wedge-like form where the oil moves gradually downward, and it then shifts horizontally towards the shoreline with thinning in oil-contaminated zones under control of tidal action and ground surface slope. Consequently, guided by remote sensing observations, in-situ trenches/wells are suggested to withdraw the oil-contaminated water at the maximum deduced oil-contaminated soil thickness. The applied procedures in this study are replicable and can be effectively used as a pre-requisite to remedy oil spills along terrestrial coastal environments worldwide.

Improving environmental and economic sustainability of cutlery manufacturing in a developing nation through energy reduction and energy transition initiatives.

Manufacturing industries are vital for economic development, but they cause significant environmental damages. As there are scarce research studies for this industrial sector from developing countries, this article reports a comprehensive environmental and economic analyses for cutlery manufacturing in Pakistan. SimaPro 9.5 was used as a modelling software tool, while ReCiPe 2016 methods were used to evaluate various midpoint and endpoint environmental impacts. Various economic indicators were used to evaluate the economic performance of different alternative scenarios. The results revealed that injection molding process, due to its energy-intensive nature caused the most environmental impacts as compared to other manufacturing processes. Global warming and terrestrial ecotoxicity were the most affected impact categories with values of 11.8 kg CO2 eq and 12.0 kg 1,4-DCB, respectively. Meanwhile, at endpoint level, human health category was most damaged as compared to others. Based on technical process intervention and energy transition, four different alternative scenarios were developed. In comparison with baseline scenario, the alternative scenario with double-cavity mold resulted in a reduction of more than 30% for various impact categories. The other three alternatives were grounded on the use of solar energy (50% or 100%) and injection mold with double or single cavity. Overall, the alternative scenario with 50% solar energy and double-cavity mold was the best solution that showed more than 50% reduction in most of the impact categories, less than 3-year payback time, 2.12 million (Pakistani Rupees) net present value, and 36.3% of return on investment. This study clearly shows the importance of renewable energy resources and simple changes in process technology for improving sustainability performance. The relevant stakeholders can effectively use the results and methodology of this study as a reference and guide for future research and practical interventions, especially in developing countries.

Integrating machine and deep learning technologies in green buildings for enhanced energy efficiency and environmental sustainability.

A green building (GB) is a design idea that integrates environmentally conscious technology and sustainable procedures throughout the building's life cycle. However, because different green requirements and performances are integrated into the building design, the GB design procedure typically takes longer than conventional structures. Machine learning (ML) and other advanced artificial intelligence (AI), such as DL techniques, are frequently utilized to assist designers in completing their work more quickly and precisely. Therefore, this study aims to develop a GB design predictive model utilizing ML and DL techniques to optimize resource consumption, improve occupant comfort, and lessen the environmental effect of the built environment of the GB design process. A dataset ASHARE-884 is applied to the suggested models. An Exploratory Data Analysis (EDA) is applied, which involves cleaning, sorting, and converting the category data into numerical values utilizing label encoding. In data preprocessing, the Z-Score normalization technique is applied to normalize the data. After data analysis and preprocessing, preprocessed data is used as input for Machine learning (ML) such as RF, DT, and Extreme GB, and Stacking and Deep Learning (DL) such as GNN, LSTM, and RNN techniques for green building design to enhance environmental sustainability by addressing different criteria of the GB design process. The performance of the proposed models is assessed using different evaluation metrics such as accuracy, precision, recall and F1-score. The experiment results indicate that the proposed GNN and LSTM models function more accurately and efficiently than conventional DL techniques for environmental sustainability in green buildings.

Mitigating the systemic loss of nitrous oxide: a narrative review and data-driven practice analysis.

Given the negative health impacts of climate change, clinicians have a fundamental responsibility to take an active role in mitigating the environmental impact of their practices. Inhaled anaesthetics are potent greenhouse gases, including nitrous oxide (N2O), with their long atmospheric lifetime, high global warming potential, and ozone-depleting properties. However, few clinicians realise that losses from central N2O supply systems account for the vast majority of overall N2O consumption in healthcare. Central N2O supply systems are standard in most facilities, compounding the impact of these under-recognised, unnecessary greenhouse gas emissions. We review the environmental impact of N2O in healthcare, offer N2O utilisation data from 47 hospitals in the USA, and provide clinician-targeted guidance for mitigating these widespread N2O emissions. Consistent with findings from the UK and Australia, data from two large US healthcare systems reveal significant nonclinical N2O losses of 47.2-99.8% of total procured N2O. As illustrated in one quaternary medical centre, the transition from central to portable supply systems reduced overall N2O consumption by 97.6%. To date, this mitigation initiative has been successfully implemented at over 25 hospitals in our system. Raising awareness of this considerable source of healthcare-specific N2O emissions empowers clinicians to spearhead facility-level engagement and action. As healthcare leaders, clinicians should advocate for decarbonisation of clinical practices and systems while ensuring high-quality patient care.