Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

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

[InlineMediaObject not available: see fulltext.] Synthesis of indoles under the action of visible light (microreview)

[Figure not available: see fulltext.][Figure not available: see fulltext.]This microreview considers the use of visible light and photoredox catalysis for the synthesis of a widely used class of compounds – indoles, covering literature sources starting from 2012. The synthetic approaches are categorized according to their catalytic mechanism. © 2018, Springer Science+Business Media, LLC, part of Springer Nature

[InlineMediaObject not available: see fulltext.] Synthesis of indoles under the action of visible light (microreview)

[Figure not available: see fulltext.][Figure not available: see fulltext.]This microreview considers the use of visible light and photoredox catalysis for the synthesis of a widely used class of compounds – indoles, covering literature sources starting from 2012. The synthetic approaches are categorized according to their catalytic mechanism. © 2018, Springer Science+Business Media, LLC, part of Springer Nature

Synthesis of pyrazino[1,2-a]indoles and indolo-[1,2-a]quinoxalines (microreview)

[Figure not available: see fulltext.][Figure not available: see fulltext.] The review is dedicated to the methods of synthesis of pyrazino[1,2-a]indoles and indolo[1,2-a]-quinoxalines. The primary approach to the synthesis of these heterocyclic systems is the annulation of a pyrazine ring to a functionalized indole ring by means of condensation of carbonyl compounds, radical reactions catalyzed by transition metals, as well as hypervalent iodine compounds.[Figure not available: see fulltext.] © 2016, Springer Science+Business Media New York

Synthesis of pyrazino[1,2-a]indoles and indolo-[1,2-a]quinoxalines (microreview)

[Figure not available: see fulltext.][Figure not available: see fulltext.] The review is dedicated to the methods of synthesis of pyrazino[1,2-a]indoles and indolo[1,2-a]-quinoxalines. The primary approach to the synthesis of these heterocyclic systems is the annulation of a pyrazine ring to a functionalized indole ring by means of condensation of carbonyl compounds, radical reactions catalyzed by transition metals, as well as hypervalent iodine compounds.[Figure not available: see fulltext.] © 2016, Springer Science+Business Media New York

Domino reactions based on Knoevenagel condensation in the synthesis of heterocyclic compounds. Recent advances

[No abstract available