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

Total Syntheses of Durgamone, Nakorone and Abudinol B via Biomimetic Oxa- and Carbacyclizations

The first biomimetic total syntheses of ent-nakorone, ent-durgamone, and ent-abudinol B were accomplished by combining features of tandem polyepoxide cyclization with biomimetic polyene cyclization. The present biomimetic synthesis route offers efficient access to these marine natural products. In addition, the synthesis of the tetrasubstituted alkene of ent-abudinol B demonstrates the application of palladium-catalyzed cross-coupling of two different polycyclic ketones via the corresponding vinyl triflates, followed by partial hydrogenation of the resulting conjugated diene. Copyright © 2007 American Chemical Society

Biomimetic Syntheses from Squalene-Like Precursors: Synthesis of Ent- Abudinol B, and Reassessment of the Structure of Muzitone

We achieved the stereoselective syntheses of two different structural patterns corresponding to the enantiomers of the marine natural products abudinol B and muzitone, by developing two-directional tandem biomimetic cyclizations of polyepoxides of squalene analogues in which one alkene was functionalized as an enolsilane. In the course of this work, we demonstrated that the structure of muzitone was misassigned. © 2010 American Chemical Society

Water Oxidation Catalyzed by a New Tetracobalt-Substituted Polyoxometalate Complex: [{Co4(µ-OH)(H2O)3}(Si2W19O70)]11

A new polyoxometalate of earth adundant elements [{Co(4)(μ-OH)(H(2)O)(3)}(Si(2)W(19)O(70))](11-) has been synthesized, characterized and shown to be a water oxidation catalyst. The initial catalytic complex is unstable and slowly undergoes hydrolysis. The hydrolysis products have been isolated and characterized, and their catalytic water oxidation activity is assessed

Redox-Active Bis(phenolate) N-Heterocyclic Carbene [OCO] Pincer Ligands Support Cobalt Electron Transfer Series Spanning Four Oxidation States

A new family of low-coordinate Co complexes supported by three redox-noninnocent tridentate [OCO] pincer-type bis(phenolate) N-heterocyclic carbene (NHC) ligands are described. Combined experimental and computational data suggest that the charge-neutral four-coordinate complexes are best formulated as Co(II) centers bound to closed-shell [OCO]2– dianions, of the general formula [(OCO)CoIIL] (where L is a solvent-derived MeCN or THF). Cyclic voltammograms of the [(OCO)CoIIL] complexes reveal three oxidations accessible at potentials below 1.2 V vs Fc+/Fc, corresponding to generation of formally Co(V) species, but the true physical/spectroscopic oxidation states are much lower. Chemical oxidations afford the mono- and dications of the imidazoline NHC-derived complex, which were examined by computational and magnetic and spectroscopic methods, including single-crystal X-ray diffraction. The metal and ligand oxidation states of the monocationic complex are ambiguous; data are consistent with formulation as either [(SOCO)CoIII(THF)2]+ containing a closed-shell [SOCO]2– diphenolate ligand bound to a S = 1 Co(III) center, or [(SOCO•)CoII(THF)2]+ with a low-spin Co(II) ion ferromagnetically coupled to monoanionic [SOCO•]− containing a single unpaired electron distributed across the [OCO] framework. The dication is best described as [(SOCO0)CoII(THF)3]2+, with a single unpaired electron localized on the d7 Co(II) center and a doubly oxidized, charge-neutral, closed-shell SOCO0 ligand. The combined data provide for the first time unequivocal and structural evidence for [OCO] ligand redox activity. Notably, varying the degree of unsaturation in the NHC backbone shifts the ligand-based oxidation potentials by up to 400 mV. The possible chemical origins of this unexpected shift, along with the potential utility of the [OCO] pincer ligands for base-metal-mediated organometallic coupling catalysis, are discussed

A Palladium-oxo complex. Stabilization of this proposed catalytic intermediate by an encapsulating polytungstate ligand

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