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

Periodic Mesoporous Organosilica containing Imidazolium groups for heterogeneous catalysis

International audienc

Imidazolium functionalized SBA-15 type silica: efficient organocatalysts for Henry and cycloaddition reactions

International audienceWe report the synthesis of mesoporous SBA-15 type silica bearing ionic imidazolium substructures. Surface functionalization was achieved via post-synthesis grafting reactions using bis-silylated imidazolium precursors onto a mesoporous SBA-15 type silica support. The grafting reactions were monitored via solid state NMR spectroscopy, nitrogen sorption, transmission electron microscopy and thermogravimetry. Post synthesis grafting is the most convenient way to achieve highly stable functionalized solids displaying excellent accessibility of the immobilized functional groups combined with high chemical stability. The solids obtained via post synthesis grafting reactions appeared as highly efficient and reusable heterogeneous organocatalysts for Henry reactions and the cycloadditions of CO2 to epichlorohydrin

Pore size control and organocatalytic properties of nanostructured silica hybrid materials containing amino and ammonium groups

International audiencePeriodic mesoporous organosilicas containing amine and ammonium substructures were synthesized via soft templating approaches using anionic surfactants. Pore size control was achieved either using anionic surfactants containing alkyl groups of variable chain lengths or by addition of swelling agents such as mesitylene (1,3,5-trimethylbenzene, TMB) to the hydrolysis-polycondensation mixture. The addition of mesitylene allows to increase the pore size in the materials from 2 to 6 nm. The materials appear as versatile and recyclable heterogeneous organocatalysts in Knoevenagel and Henry reactions and in the formation of monoglycerides by ring opening reaction of glycidol. This study highlights the huge potential of silica hybrid materials containing ionic substructures (i-silica) materials in heterogeneous catalysis

Periodic mesoporous organosilica from zwitterionic precursors

International audienceMesoporous hybrid silica bearing zwitterionic species were synthesized via template directed hydrolysis-polycondensation reactions from zwitterionic ammonium-sulfonate precursors. The formation of nanostructured phases involves specific precursor-template interactions. The obtained materials are efficient heterogeneous catalysts in Biginelli reactions