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

Exclusive photoproduction of pi degrees up to large values of Mandelstam variables s, t, and u with CLAS

Exclusive photoproduction cross sections have been measured for the process $\gamma p \rightarrow p\pi^0(e^+e^-(\gamma))$ with the Dalitz decay final state using tagged photon energies in the range of $E_{\gamma} = 1.275-5.425$ GeV. The complete angular distribution of the final state $\pi^0$, for the entire photon energy range up to large values of $t$ and $u$, has been measured for the first time. The data obtained show that the cross section $d\sigma/dt$, at mid to large angles, decreases with energy as $s^{-6.89\pm 0.26}$. This is in agreement with the perturbative QCD quark counting rule prediction of $s^{-7}$. Paradoxically, the size of angular distribution of measured cross sections is greatly underestimated by the QCD based Generalized Parton Distribution mechanism at highest available invariant energy $s=11$ GeV$^2$. At the same time, the Regge exchange based models for $\pi^0$ photoproduction are more consistent with experimental data.Comment: 7 pages, 6 figure

Gamma-ray astronomy and cosmic-ray physics with ARGO-YBJ

The ARGO-YBJ detector, located 4300 m a.s.l. on the Tibet plateau, is a ground-based, full- coverage array of Resistive Plate Chambers (RPCs) covering a surface of 78×74 m2, surrounded by a guard ring of RPCs enclosing a total surface of about 11000 m2. ARGO-YBJ was designed to detect extensive air showers generated by cosmic rays and gamma rays with primary energy greater than few hundred GeV, in order to study the region of the cosmic-ray spectrum out of the reach of both satellite-based experiments and traditional ground-based arrays. The experiment has been running with its complete layout since November 2007, collecting over 2:5×1011 events. The main results obtained by ARGO-YBJ will be presented here, and specifically: the monitoring of astronomical gamma-ray sources, such as the Crab nebula and the MRK 421 AGN, the moon shadow, the medium-scale anisotropy map, the proton-proton inelastic cross section at center-of- mass energy between 70 and 500 GeV where no accelerator data are available

Gamma-ray astronomy with ARGO-YBJ

ARGO-YBJ is a full coverage air shower array located at the YangBaJing Cosmic Ray Laboratory (Tibet, P.R. China, 4300 m a.s.l., 606 g/cm2) recording data with a duty cycle ≥85% and an energy threshold of a few hundred GeV. In this paper the latest results in Gamma-Ray Astronomy are summarized