RESUMEN
Climate change and the destruction of ecosystems by human activities are among the greatest challenges of the 21st century and require urgent action. Health care activities significantly contribute to the emission of greenhouse gases and waste production, with gastrointestinal (GI) endoscopy being one of the largest contributors. This Position Statement aims to raise awareness of the ecological footprint of GI endoscopy and provides guidance to reduce its environmental impact. The European Society of Gastrointestinal Endoscopy (ESGE) and the European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) outline suggestions and recommendations for health care providers, patients, governments, and industry. MAIN STATEMENTS 1: GI endoscopy is a resource-intensive activity with a significant yet poorly assessed environmental impact. 2: ESGE-ESGENA recommend adopting immediate actions to reduce the environmental impact of GI endoscopy. 3: ESGE-ESGENA recommend adherence to guidelines and implementation of audit strategies on the appropriateness of GI endoscopy to avoid the environmental impact of unnecessary procedures. 4: ESGE-ESGENA recommend the embedding of reduce, reuse, and recycle programs in the GI endoscopy unit. 5: ESGE-ESGENA suggest that there is an urgent need to reassess and reduce the environmental and economic impact of single-use GI endoscopic devices. 6: ESGE-ESGENA suggest against routine use of single-use GI endoscopes. However, their use could be considered in highly selected patients on a case-by-case basis. 7: ESGE-ESGENA recommend inclusion of sustainability in the training curricula of GI endoscopy and as a quality domain. 8: ESGE-ESGENA recommend conducting high quality research to quantify and minimize the environmental impact of GI endoscopy. 9: ESGE-ESGENA recommend that GI endoscopy companies assess, disclose, and audit the environmental impact of their value chain. 10: ESGE-ESGENA recommend that GI endoscopy should become a net-zero greenhouse gas emissions practice by 2050.
Asunto(s)
Gastroenterología , Ecosistema , Endoscopía Gastrointestinal/métodos , HumanosRESUMEN
Poly(N-vinylcarbazole) films can be deposited at the three-phase boundary when the organic phase contains only monomer, N-vinylcarbazole, while the aqueous phase contains supporting electrolyte. A cylindrical platinum microelectrode is immersed into the two-liquid system in such a way that a part of it is located in one liquid and the other part resides in the second liquid. The thickness of the reaction layer, or the width of the microelectrode zone where the polymer grows, depends on the kind of ions present in the aqueous phase and the time of the experiment. The structure of the deposited polymer may be very different and depends on the distance from the three-phase boundary and the type of the anion present in the aqueous phase. The key parameters here are the local electrode potential and the local concentration of the anions. The list of obtained polymer structures includes, among others, arrays of perfectly arranged deep oval channels and groups of microcrystals. The porosity of the polymer deposits increases with the distance from the aqueous phase.