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

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

Charge-transfer complexes formed in the reaction of 1,4,7,10-tetraazacyclododecane with π-electron acceptors

Abstract The reactions of the electron donor 1,4,7,10-tetraazacyclododecane (TACDD) with the π-electron acceptors 7,7,8,8-tetracyanoquinodimethane (TCNQ), tetracyanoethylene (TCNE), 2,3-dichloro-5,6-dicyano-p-benzoquinone (DDQ), 2,3,5,6-tetrachloro-1,4-benzoquinone (CHL) and 2,4,4,6-tetrabromo-2,5-cyclohexadienone (TBCHD) were studied spectrophotometrically in chloroform at room temperature. The electronic and infrared spectra of the formed molecular charge-transfer (CT) complexes were recorded. The obtained results showed that the stoichiometries of the reactions are fixed and depend on the nature of both the donor and the acceptor.Based on the obtained data, the formed charge-transfer complexes were formulated as [(Donor)(Acceptor)2] for the donor (TACDD) and the acceptors TCNQ, TCNE, DDQ, CHL and TBCHD. These CT-complexes were isolated as solids and have been characterized through electronic and infrared spectra as well as elemental and thermal analysis measurements. The formation constants (KCT), charge transfer energy (ECT), molar extinction coefficients (εCT), free energy change ΔG0, ionization potential Ip and oscillator strength ƒ of the formed CT-complexes were obtained

Synthesis, spectroscopic and thermal studies of charge-transfer molecular complexes formed in the reaction of 1,4-bis (3-aminopropyl) piperazine with σ- and π acceptors

Abstract In the present study, solid charge-transfer (CT) molecular complexes formed in the reaction of the electron donor 1,4-bis (3-aminopropyl) piperazine (APPIP) with the σ-electron acceptor iodine and π-acceptors 7,7,8,8-tetracyanoquinodimethane (TCNQ), tetracyanoethylene (TCNE), 2,3-dichloro-5,6-dicyano-1,4-benzoquinone (DDQ), and 2,4,4,6-tetrabromo-2,5-cyclohexadienone (TBCHD) have been investigated spectrophotometrically in chloroform at 25°C. These were characterized through electronic and infrared spectra as well as elemental and thermal analysis. The obtained results showed that the formed solid CT-complexes have the formulas [(APPIP) I]+I3-, [(APPIP)(TCNQ)], [(APPIP)2(TCNE)3], [(APPIP)(DDQ)] and [(APPIP)(TBCHD)] in full agreement with the known reaction stoichiometries in solution as well as the elemental measurements. The formation constant KCT, molar extinction coefficient εCT, free energy change ΔG0, CT energy ECT and the ionization potential Ip have been calculated for the CT complexes [(APPIP) I]+I3-, [(APPIP)(TCNQ)], [(APPIP)(DDQ)] and [(APPIP)(TBCHD)]

Charge-transfer complexes of 4-methylpiperidine with σ- and π-acceptors

The solid charge-transfer (CT) molecular complexes formed in the reaction of the electron donor 4-methylpiperidine (4MP) with the σ-electron acceptor iodine and π-acceptors 7,7,8,8-tetracyanoquinodimethane (TCNQ), 2,3-dichloro-5,6-dicyano-1,4-benzoquinone (DDQ) and 2,4,4,6-tetrabromo-2,5-cyclohexadienone (TBCHD) have been investigated spectrophotometrically in chloroform at 25°C. These were characterized through electronic and infrared spectra as well as elemental and thermal analysis. The obtained results showed that the formed solid CT-complexes have the formulas [(4MP) I]+I−3, [(4MP)(DDQ)2] and [(4MP)(TBCHD)] and with TCNQ the adduct [TCMPQDM] is obtained through N-substitution reaction in full agreement with the known reaction stoichiometries in solution as well as the elemental measurements.The formation constant KCT, molar extinction coefficient εCT, free energy change ΔG0, CT energy ECT and the ionization potential Ip have been calculated for the CT-complexes [(4MP) I]+I−3, [(4MP)(DDQ)2] and [(4MP)(TBCHD)]

Synthesis, spectroscopic, thermal and structural investigations of charge-transfer complexes of 4,4′-trimethylenedipiperidine with chloranil, TBCHD, DDQ, TCNQ and iodine

The charge-transfer interactions between the electron donor 4,4′-trimethylenedipiperidine (TMDP) and the acceptors 2,3,5,6-tetrachloro-1,4-benzoquinone (chloranil), 2,4,4,6-tetrabromo-2,5-cyclohexadienone (TBCHD), 2,3-dichloro-5,6-dicyano-1,4-benzoquinone (DDQ), 7,7′,8,8′-tetracyanoquinodimethane (TCNQ) and iodine have been studied spectrophotometrically in CHCI3 solutions. The formed solid charge-transfer complexes were also isolated and characterized through infrared spectra as well as thermal and elemental analysis. The stoichiometry of the complexes was found to be 1:1 in the case of TMDP–chloranil and TMDP–TBCHD systems and 1:2 in the case of TMDP–DDQ and TMDP–TCNQ systems and 1:3 in the case of TMDP–iodine system. Taking this into consideration along with infrared spectra and thermal and elemental analysis, the formed CT-complexes have the formulas [(TMDP)(chloranil)], [(TMDP)(TBCHD)], [(TMDP)(DDQ)2] [(TMDP)(TCNQ)2] and [(TMDP)I]+·I5−, respectively

Synthesis, spectroscopic and thermal structural investigations of the charge-transfer complexes formed in the reaction of 1-methylpiperidine with σ- and π-acceptors

The reactions of the electron donor 1-methylpiperidine (1MP) with the π-acceptors 7,7,8,8-tetracyanoquinodimethane (TCNQ), tetracyanoethylene (TCNE), 2,3-dichloro-5,6-dicyano-p-benzoquinone (DDQ), 2,3,5,6-tetrachloro-1,4-benzoquinone (chloranil = CHL) and iodine (I2) were studied spectrophotometrically in chloroform at room temperature. The electronic and infrared spectra of the formed molecular charge-transfer (CT) complexes were recorded. The obtained results showed that the stoichiometries of the reactions are not fixed and depend on the nature of the acceptor. Based on the obtained data, the formed charge-transfer complexes were formulated as [(1MP)(TCNE)2], [(1MP)(DDQ)]·H2O, [(1MP)(CHL)] and [(1MP)I]I3, while in the case of 1MP-TCNQ reaction, a short-lived CT complex is formed followed by rapid N-substitution by TCNQ forming the final reaction products 7,7,8-tricyano-8-piperidinylquinodimethane (TCPQDM). The five solids products were isolated and have been characterized by electronic spectra, infrared spectra, elemental analysis and thermal analysis. © 2009 Elsevier B.V. All rights reserved

Synthesis, spectroscopic and thermal investigations of solid charge-transfer complexes of 1,4,7-trimethyl-1,4,7-triazacyclononane and the acceptors iodine, TCNE, TCNQ and chloranil

The solid charge-transfer complexes formed in the reaction of the electron donor 1,4,7-trimethyl-1,4,7-triazacyclononane (TMTACN) with the acceptors iodine, tetracyanoethylene (TCNE) and 7,7,8,8-tetracyanoquinodimethane (TCNQ) have been isolated. These were characterized through electronic and infrared spectra as well as thermal and elemental analysis. The results show that the formed solid CT-complexes have the formulas [(TMTACN)I]I3, [(TMTACN)(TCNE)5] and [(TMTACN)(TCNQ)3] in full agreement with the known reaction stoichiometries in solution. The chloranil CT-solid complex cannot be isolated in pure form

Novel charge transfer complexes of the donor 1,4,7,10,13,16-hexamethyl-1,4,7,10,13,16-hexaazacyclooctadecane and the acceptors iodine, TCNE, and TCNQ

Abstract Novel charge transfer complexes have been formed in the reaction of the interesting powerful electron donor 1,4,7,10,13,16-hexamethyl-1,4,7,10,13,16-hexaazacyclooctadecane (HMHACOD) with σ-electron acceptor iodine and π-acceptors tetracynoethylene (TCNE) and 7,7,8,8,-tetracyanoquinodimethane (TCNQ).The reactions have been studied spectrophotometrically in chloroform and the formed solid complexes have been isolated and characterized through infrared spectra as well as thermal and elemental analysis. Due to the expected powerful electron donation of the donor (HMHACOD), the reaction stoichiometries, donor:acceptor molar ratio values, are found to be exceptionally high equal to 1:6, 1:16 and 1:3 for iodine, TCNE and TCNQ complexes, respectively. Accordingly the formed charge transfer complexes could be formulated as [(HMHACOD)I]+·I11-, [(HMHACOD)(TCNE)16] and [(HMHACOD)(TCNQ)3]

Synthesis and spectroscopic structural investigations of the charge-transfer complexes formed in the reaction of 2,6-diaminopyridine with π-acceptors TCNE, chloranil, and DDQ

Molecular charge-transfer complexes of the donor 2,6-diaminopyridine (2,6-DAPY) with π-acceptors tetracyanoethylene (TCNE), 2,3-dichloro-5,6-dicyano-p-benzoquinone (DDQ) and tetrachloro-p-benzoquinone(chloranil) were studied spectrophotometrically in chloroform at room temperature. All formed complexes exhibit well resolved charge-transfer bands in the regions where neither donor nor acceptors have any absorption. The stoichiometries of the reactions were determined from photometric titration methods. The results obtained show the formed CT complexes have the structures [(2,6-DAPY)(TCNE)3], [(2,6-DAPY)(DDQ)2], and [(2,6-DAPY)(chloranil)]. These three complexes were isolated as solids and further characterized by elemental analysis and infrared measurements