Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

An Intelligent Decision Support System Inspired by Newton’s Laws of Motion

International audienceThe purpose of this study is to present a novel perspective on decision technology based on classical physics rules, considering risks and opportunities as physical forces deviating systems as an object from their stable states. The forces are created by changing the internal and external characteristics of the system. The ultimate objective is to propose a multi-criteria performance framework within the geometrical space of the system Key Performance Indicators (KPIs) based on classical physics rules by mapping management concepts onto physical notations. The present study is tuned to a model of interaction between the inventory management module and the workforce supply chain to present the main work. In addition, the significance of the study as an intelligent decision system to manage the given model through Newton laws is investigated

PREMIERES JOURNEES INTERSCIENCES DE TOULOUSE 16 et 17 novembre 2023 : Compte-rendu et réflexions

Meeting today's challenges - be they climatic, health, energy, digital or food-related - requires the mobilization of all fields of knowledge. The complexity of the problems we face does not lend itself well to monodisciplinary expertise: it is only through the development of a more global and integrated approach, known as “interscience”, that innovative thinking and solutions can emerge. To prepare for this, new instruments need to be invented at the crossroads of higher education, research and societal issues.The first Journées Intersciences de Toulouse (JIT 2023) consisted of a combination of keynote lectures and round-table discussions bringing together specialists in the practice of interscience in terms of research, teaching and the creation of tomorrow's professions.Relever les défis actuels, qu’ils soient climatiques, sanitaires, énergétiques, numériques ou encore alimentaires, nécessite de mobiliser tous les champs de la connaissance. La complexité des problèmes auxquels nous sommes confrontés se prête mal à l’expertise mono-disciplinaire : c’est seulement par le développement d’une approche plus globale et intégrée, nommée « intersciences », que des réflexions et solutions innovantes pourront émerger. Pour s'y préparer, de nouveaux instruments sont à inventer au carrefour de l'enseignement supérieur, de la recherche et des enjeux sociétaux.Ces premières Journées Intersciences de Toulouse (JIT 2023) ont consisté en une articulation entre des conférences de référence et des tables rondes regroupant des spécialistes de la pratique de l’intersciences en termes de recherche, enseignement et fabrique des métiers de demain

PREMIERES JOURNEES INTERSCIENCES DE TOULOUSE 16 et 17 novembre 2023 : Compte-rendu et réflexions

Meeting today's challenges - be they climatic, health, energy, digital or food-related - requires the mobilization of all fields of knowledge. The complexity of the problems we face does not lend itself well to monodisciplinary expertise: it is only through the development of a more global and integrated approach, known as “interscience”, that innovative thinking and solutions can emerge. To prepare for this, new instruments need to be invented at the crossroads of higher education, research and societal issues.The first Journées Intersciences de Toulouse (JIT 2023) consisted of a combination of keynote lectures and round-table discussions bringing together specialists in the practice of interscience in terms of research, teaching and the creation of tomorrow's professions.Relever les défis actuels, qu’ils soient climatiques, sanitaires, énergétiques, numériques ou encore alimentaires, nécessite de mobiliser tous les champs de la connaissance. La complexité des problèmes auxquels nous sommes confrontés se prête mal à l’expertise mono-disciplinaire : c’est seulement par le développement d’une approche plus globale et intégrée, nommée « intersciences », que des réflexions et solutions innovantes pourront émerger. Pour s'y préparer, de nouveaux instruments sont à inventer au carrefour de l'enseignement supérieur, de la recherche et des enjeux sociétaux.Ces premières Journées Intersciences de Toulouse (JIT 2023) ont consisté en une articulation entre des conférences de référence et des tables rondes regroupant des spécialistes de la pratique de l’intersciences en termes de recherche, enseignement et fabrique des métiers de demain

PREMIERES JOURNEES INTERSCIENCES DE TOULOUSE 16 et 17 novembre 2023 : Compte-rendu et réflexions

Meeting today's challenges - be they climatic, health, energy, digital or food-related - requires the mobilization of all fields of knowledge. The complexity of the problems we face does not lend itself well to monodisciplinary expertise: it is only through the development of a more global and integrated approach, known as “interscience”, that innovative thinking and solutions can emerge. To prepare for this, new instruments need to be invented at the crossroads of higher education, research and societal issues.The first Journées Intersciences de Toulouse (JIT 2023) consisted of a combination of keynote lectures and round-table discussions bringing together specialists in the practice of interscience in terms of research, teaching and the creation of tomorrow's professions.Relever les défis actuels, qu’ils soient climatiques, sanitaires, énergétiques, numériques ou encore alimentaires, nécessite de mobiliser tous les champs de la connaissance. La complexité des problèmes auxquels nous sommes confrontés se prête mal à l’expertise mono-disciplinaire : c’est seulement par le développement d’une approche plus globale et intégrée, nommée « intersciences », que des réflexions et solutions innovantes pourront émerger. Pour s'y préparer, de nouveaux instruments sont à inventer au carrefour de l'enseignement supérieur, de la recherche et des enjeux sociétaux.Ces premières Journées Intersciences de Toulouse (JIT 2023) ont consisté en une articulation entre des conférences de référence et des tables rondes regroupant des spécialistes de la pratique de l’intersciences en termes de recherche, enseignement et fabrique des métiers de demain

PREMIERES JOURNEES INTERSCIENCES DE TOULOUSE 16 et 17 novembre 2023 : Compte-rendu et réflexions

Meeting today's challenges - be they climatic, health, energy, digital or food-related - requires the mobilization of all fields of knowledge. The complexity of the problems we face does not lend itself well to monodisciplinary expertise: it is only through the development of a more global and integrated approach, known as “interscience”, that innovative thinking and solutions can emerge. To prepare for this, new instruments need to be invented at the crossroads of higher education, research and societal issues.The first Journées Intersciences de Toulouse (JIT 2023) consisted of a combination of keynote lectures and round-table discussions bringing together specialists in the practice of interscience in terms of research, teaching and the creation of tomorrow's professions.Relever les défis actuels, qu’ils soient climatiques, sanitaires, énergétiques, numériques ou encore alimentaires, nécessite de mobiliser tous les champs de la connaissance. La complexité des problèmes auxquels nous sommes confrontés se prête mal à l’expertise mono-disciplinaire : c’est seulement par le développement d’une approche plus globale et intégrée, nommée « intersciences », que des réflexions et solutions innovantes pourront émerger. Pour s'y préparer, de nouveaux instruments sont à inventer au carrefour de l'enseignement supérieur, de la recherche et des enjeux sociétaux.Ces premières Journées Intersciences de Toulouse (JIT 2023) ont consisté en une articulation entre des conférences de référence et des tables rondes regroupant des spécialistes de la pratique de l’intersciences en termes de recherche, enseignement et fabrique des métiers de demain

PREMIERES JOURNEES INTERSCIENCES DE TOULOUSE 16 et 17 novembre 2023 : Compte-rendu et réflexions

Meeting today's challenges - be they climatic, health, energy, digital or food-related - requires the mobilization of all fields of knowledge. The complexity of the problems we face does not lend itself well to monodisciplinary expertise: it is only through the development of a more global and integrated approach, known as “interscience”, that innovative thinking and solutions can emerge. To prepare for this, new instruments need to be invented at the crossroads of higher education, research and societal issues.The first Journées Intersciences de Toulouse (JIT 2023) consisted of a combination of keynote lectures and round-table discussions bringing together specialists in the practice of interscience in terms of research, teaching and the creation of tomorrow's professions.Relever les défis actuels, qu’ils soient climatiques, sanitaires, énergétiques, numériques ou encore alimentaires, nécessite de mobiliser tous les champs de la connaissance. La complexité des problèmes auxquels nous sommes confrontés se prête mal à l’expertise mono-disciplinaire : c’est seulement par le développement d’une approche plus globale et intégrée, nommée « intersciences », que des réflexions et solutions innovantes pourront émerger. Pour s'y préparer, de nouveaux instruments sont à inventer au carrefour de l'enseignement supérieur, de la recherche et des enjeux sociétaux.Ces premières Journées Intersciences de Toulouse (JIT 2023) ont consisté en une articulation entre des conférences de référence et des tables rondes regroupant des spécialistes de la pratique de l’intersciences en termes de recherche, enseignement et fabrique des métiers de demain

Biological and Neuroimaging Markers as Predictors of 5-Year Incident Frailty in Older Adults: A Secondary Analysis of the MAPT Study

International audienceBackground This study aims to investigate the predictive value of biological and neuroimaging markers to determine incident frailty among older people for a period of 5 years. Methods We included 1394 adults aged 70 years and older from the Multidomain Alzheimer Preventive Trial, who were not frail at baseline (according to Fried’s criteria) and who had at least 1 post-baseline measurement of frailty. Participants who progressed to frailty during the 5-year follow-up were categorized as “incident frailty” and those who remained non-frail were categorized as “without frailty.” The differences of baseline biochemical factors (25-hydroxyvitamin D, homocysteine, omega-3 index, C-reactive protein), other biological markers (Apolipoprotein E genotypes, amyloid-β deposits), and neuroimaging data (gray matter volume, hippocampal volume, white matter hyperintensities) were compared between groups. Cox proportional hazard model was used to evaluate the associations between biomarkers and incident frailty. Results A total of 195 participants (14.0%) became frail over 5 years. Although 25-hydroxyvitamin D deficiency, homocysteine levels, low-grade inflammation (persistently increased C-reactive protein 3–10 mg/L), gray matter, and hippocampal volume were significantly associated with incident frailty in unadjusted models, these associations disappeared after adjustment for age, sex, and other confounders. Omega-3 index was the sole marker that presented a trend of association with incident frailty (hazard ratio: 0.92; 95% confidence interval: 0.83–1.01; p = .082). Conclusions This study failed to identify biomarkers able to predict frailty incidence in community-dwelling older adults for a period of 5 years. Further longitudinal research with multiple measurements of biomarkers and frailty is needed to evaluate the long-term relationships between changes in biomarkers levels and frailty evolution

Biological and Neuroimaging Markers as Predictors of 5-Year Incident Frailty in Older Adults: A Secondary Analysis of the MAPT Study

Abstract Background This study aims to investigate the predictive value of biological and neuroimaging markers to determine incident frailty among older people for a period of 5 years. Methods We included 1394 adults aged 70 years and older from the Multidomain Alzheimer Preventive Trial, who were not frail at baseline (according to Fried’s criteria) and who had at least 1 post-baseline measurement of frailty. Participants who progressed to frailty during the 5-year follow-up were categorized as “incident frailty” and those who remained non-frail were categorized as “without frailty.” The differences of baseline biochemical factors (25-hydroxyvitamin D, homocysteine, omega-3 index, C-reactive protein), other biological markers (Apolipoprotein E genotypes, amyloid-β deposits), and neuroimaging data (gray matter volume, hippocampal volume, white matter hyperintensities) were compared between groups. Cox proportional hazard model was used to evaluate the associations between biomarkers and incident frailty. Results A total of 195 participants (14.0%) became frail over 5 years. Although 25-hydroxyvitamin D deficiency, homocysteine levels, low-grade inflammation (persistently increased C-reactive protein 3–10 mg/L), gray matter, and hippocampal volume were significantly associated with incident frailty in unadjusted models, these associations disappeared after adjustment for age, sex, and other confounders. Omega-3 index was the sole marker that presented a trend of association with incident frailty (hazard ratio: 0.92; 95% confidence interval: 0.83–1.01; p = .082). Conclusions This study failed to identify biomarkers able to predict frailty incidence in community-dwelling older adults for a period of 5 years. Further longitudinal research with multiple measurements of biomarkers and frailty is needed to evaluate the long-term relationships between changes in biomarkers levels and frailty evolution. </jats:sec