Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study

PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

A delineating procedure to retrieve relevant publication data in research areas: the case of nanocellulose

Advances concerning publication-level classification system have been demonstrated striking results by dealing properly with emergent, complex and interdisciplinary research areas, such as nanotechnology and nanocellulose. However, less attention has been paid to propose a delineating method to retrieve relevant research areas on specific subjects. This study aims at proposing a procedure to delineate research areas addressed in case nanocellulose. We investigate how a bibliometric analysis could provide interesting insights into research about this sustainable nanomaterial. The research topics clustered by a Publication-level Classification System were used. The procedure involves an iterative process, which includes developing and cleaning a set of core publication regarding the subject and an analysis of clusters they are associated with. Nanocellulose was selected as the subject of study, but the methodology may be applied to any other research area or topic. A discussion about each step of the procedure is provided. The proposed delineation procedure enables us to retrieve relevant publications from research areas involving nanocellulose. Seventeen research topics were mapped and associated with current research challenges on nanocellulose.Merit, Expertise and Measuremen

Nanocomposite polymer electrolytes based on poly(oxyethylene) and cellulose whiskers

Solid lithium-conducting nanocomposite polymer electrolytes based on poly(oxyethylene) (POE) were prepared from high aspect ratio cellulosic whiskers and lithium imide salt, LiTFSI. The cellulosic whiskers were extracted from tunicate -a sea animal- and consisted of slender parallelepiped rods that have an average length around 1 µm and a width close to 15 nm. High performance nanocomposite electrolytes were obtained. The filler provided a high reinforcing effect while a high level of ionic conductivity was retained with respect to unfilled polymer electrolytes. Cross-linking and plasticizing of the matrix as well as preparation of the composites from an organic medium were also investigated

A simple method for the melt extrusion of cellulose nano-crystal reinforced hydrophobic polymer

International audienceThe rheological properties of a dispersion of cellulose nanocrystals (CNCs) in an aqueous solution of polyoxyethylene (PEO) have been investigated. A peculiar behavior is reported. Upon adding CNC, the viscosity of the suspension first decreases and then increases. Adsorption of PEO chains on the surface of the nanoparticles has been suspected. Freeze-drying of this PEO-adsorbed CNC dispersion was performed, and the ensuing lyophilizate was extruded with low density polyethylene. Compared to neat CNC-based nanocomposites, both improved dispersibility and thermal stability were observed. This simple and physical method constitutes an approach of choice for the melt processing of CNC-based nanocomposites with a hydrophobic polymeric matrix applicable at the industrial scale