12 research outputs found

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

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    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

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    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

    The optimized of tunable all-inorganic metal halide perovskites CsNBr

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    We report the study of chemical and physical characteristics of all-inorganic metal halide perovskites CsNBr3 (N2+  = Ge, Sn, Pb) via implementation of first-principles approaches in the framework of density functional theory (DFT) methodologies. Three different DFT approximations include Perdew–Burke–Ernzerhof (PBE), PBESOL, and Wu-Cohen (WC) within the generalized gradient approximation (GGA) based on the full-potential linearized augmented plane-wave (FPLAPW) scheme are used in unification with Kohn–Sham (KS) equation as executed in WIEN2k package. In addition, the hybrid functional (HSE06) was utilized to reproduce accurate energy-gaps (Egap) in the PBE-band-structures of CsNBr3 perovskites. It is found that the present results of GGA approaches for structural, electronic, and optical properties are consistent with the existing experimental and previous DFT data, where PBE gives values closer to experiments than others. Nonmagnetic and semiconducting properties, with reliable Egap localized at the R-symmetry point, are revealed by the three GGA results of band structures and density of states for all CsNBr3 perovskites. Moreover, the photonic energy-dependent optical properties of CsNBr3 perovskites comprising the real and imaginary parts of the dielectric function, conductivity, reflectivity, refractive index, and absorption and extinction coefficients have been realized using the GGA approaches. The semiconducting direct Egap (Egap = 0.9814–1.9086 eV) and high optical absorption implies that the three cesium bromide perovskites CsNBr3 can utilize in designing inorganic photovoltaic (PV) solar cells, photodetectors, photodiodes, and other PV devices working in ultraviolet–visible range

    Electronic and optical correlation effects in bulk gold: role of spine-orbit coupling

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    The modified Becke-Johnson exchange potential proposed by Tran and Blaha (TB-mBJ) is useful for accurate calculations of electronic band structures of solids. In this view, we used such potential together with spin–orbit coupling to calculate the electronic and optical correlation effects in bulk gold (Au) via first principle DFT. Inclusion of the relativistic effects in the simulation were found to play vital role on the optical properties of bulk Au. Furthermore, the imaginary part of the dielectric function of Au disclosed good agreement with the experimental results. Disclosure of good agreement between simulation and experimental results (up to Fermi level) was due to the improvement in the band structure of bulk Au achieved by incorporating spin–orbit coupling

    Pulsed laser ablation in liquid assisted growth of gold nanoparticles: evaluation of structural and optical features

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    High purity gold (Au) nanoparticles (NPs) with desired morphology are demanding for various applications. Being simple, versatile, and cost-effective technique, PLAL is promising for the production of impurities free nanoparticles (NPs) of diverse materials. This paper reports the preparation and characterization of colloidal Au-NPs. Such Au-NPs were produced via PLAL route, wherein the Au target was immersed inside deionized water and ablated using a Q-switched Nd:YAG laser (wavelength 1064 nm and pulse width 8 ns). The structural, morphological, and optical characteristics of the as-synthesized Au-NPs were evaluated as a function of varied laser energies and repetition rates. Optical traits of Au-NPs were analyzed by ultraviolet–visible (UV–Vis) absorption, photoluminescence, and Raman spectroscopy. Surface plasmon resonance (SPR) absorbance at the excitation wavelength of 633 nm was recorded to find the shape of the Au-NPs. Attenuated total reflection infrared (ATR-IR) spectra was obtained to verify the achieved Au-NPs purity. High-resolution transmission electron micrographs approved the nucleation of spherical colloidal Au-NPs (mean diameter of 7 to 30 nm) in deionized water. The UV–Vis spectra of Au-NPs disclosed the occurrences of SPR peaks in the range of 521 to 524 nm accompanied by blue-shift. The UV absorption edge of the UV–Vis spectra was used to determine the optical band gap energies of the produced Au-NPs which were further confirmed by the photoluminescence spectral analyses. Present findings based on PLAL-assisted synthesis of pure Au-NPs may be beneficial for the development photocatalysis and solar cells

    Head and neck cancer surgery during the COVID-19 pandemic: An international, multicenter, observational cohort study

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    Background: The aims of this study were to provide data on the safety of head and neck cancer surgery currently being undertaken during the coronavirus disease 2019 (COVID-19) pandemic. Methods: This international, observational cohort study comprised 1137 consecutive patients with head and neck cancer undergoing primary surgery with curative intent in 26 countries. Factors associated with severe pulmonary complications in COVID-19–positive patients and infections in the surgical team were determined by univariate analysis. Results: Among the 1137 patients, the commonest sites were the oral cavity (38%) and the thyroid (21%). For oropharynx and larynx tumors, nonsurgical therapy was favored in most cases. There was evidence of surgical de-escalation of neck management and reconstruction. Overall 30-day mortality was 1.2%. Twenty-nine patients (3%) tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) within 30 days of surgery; 13 of these patients (44.8%) developed severe respiratory complications, and 3.51 (10.3%) died. There were significant correlations with an advanced tumor stage and admission to critical care. Members of the surgical team tested positive within 30 days of surgery in 40 cases (3%). There were significant associations with operations in which the patients also tested positive for SARS-CoV-2 within 30 days, with a high community incidence of SARS-CoV-2, with screened patients, with oral tumor sites, and with tracheostomy. Conclusions: Head and neck cancer surgery in the COVID-19 era appears safe even when surgery is prolonged and complex. The overlap in COVID-19 between patients and members of the surgical team raises the suspicion of failures in cross-infection measures or the use of personal protective equipment. Lay Summary: Head and neck surgery is safe for patients during the coronavirus disease 2019 pandemic even when it is lengthy and complex. This is significant because concerns over patient safety raised in many guidelines appear not to be reflected by outcomes, even for those who have other serious illnesses or require complex reconstructions. Patients subjected to suboptimal or nonstandard treatments should be carefully followed up to optimize their cancer outcomes. The overlap between patients and surgeons testing positive for severe acute respiratory syndrome coronavirus 2 is notable and emphasizes the need for fastidious cross-infection controls and effective personal protective equipment

    Delaying surgery for patients with a previous SARS-CoV-2 infection

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    Head and neck cancer surgery during the COVID-19 pandemic: An international, multicenter, observational cohort study

    Get PDF
    Background: The aims of this study were to provide data on the safety of head and neck cancer surgery currently being undertaken during the coronavirus disease 2019 (COVID-19) pandemic. Methods: This international, observational cohort study comprised 1137 consecutive patients with head and neck cancer undergoing primary surgery with curative intent in 26 countries. Factors associated with severe pulmonary complications in COVID-19–positive patients and infections in the surgical team were determined by univariate analysis. Results: Among the 1137 patients, the commonest sites were the oral cavity (38%) and the thyroid (21%). For oropharynx and larynx tumors, nonsurgical therapy was favored in most cases. There was evidence of surgical de-escalation of neck management and reconstruction. Overall 30-day mortality was 1.2%. Twenty-nine patients (3%) tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) within 30 days of surgery; 13 of these patients (44.8%) developed severe respiratory complications, and 3.51 (10.3%) died. There were significant correlations with an advanced tumor stage and admission to critical care. Members of the surgical team tested positive within 30 days of surgery in 40 cases (3%). There were significant associations with operations in which the patients also tested positive for SARS-CoV-2 within 30 days, with a high community incidence of SARS-CoV-2, with screened patients, with oral tumor sites, and with tracheostomy. Conclusions: Head and neck cancer surgery in the COVID-19 era appears safe even when surgery is prolonged and complex. The overlap in COVID-19 between patients and members of the surgical team raises the suspicion of failures in cross-infection measures or the use of personal protective equipment. Lay Summary: Head and neck surgery is safe for patients during the coronavirus disease 2019 pandemic even when it is lengthy and complex. This is significant because concerns over patient safety raised in many guidelines appear not to be reflected by outcomes, even for those who have other serious illnesses or require complex reconstructions. Patients subjected to suboptimal or nonstandard treatments should be carefully followed up to optimize their cancer outcomes. The overlap between patients and surgeons testing positive for severe acute respiratory syndrome coronavirus 2 is notable and emphasizes the need for fastidious cross-infection controls and effective personal protective equipment
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