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

Rate-based mass transfer performance analysis of [EMIM][EtSO4] and ethylene glycol in the extractive distillation of water-ethanol mixtures

The mass transfer efficiency of an extractive distillation column was compared for the ionic liquid 1-Ethyl-3-methylimidazolium ethyl sulfate and ethylene glycol as solvents for the separation of water-ethanol. A rate based model was established in ASPEN Plus. Tray efficiency profiles along the column showed a reduction in mass transfer performance when the ionic liquid was used due to its relatively high viscosity. Indeed, this reduction was more pronounced when the liquid phase viscosity was increased by means of a higher solvent-to-feed ratio. Finally, a sharp decline in efficiency was observed at high liquid phase viscosities, approaching the flooding point

Viscosity and density data for the ternary system water(1)-ethanol(2)-ethylene glycol(3) between 298.15 K and 328.15 K

Ethylene glycol is an organic solvent used in extractive distillation to separate water–ethanol mixtures. An appropriate process description requires accurate physical property data. In this paper, experimental liquid densities and dynamic viscosities of pure ethylene glycol as well as the ternary system water–ethanol–ethylene glycol are presented over a wide temperature range (298.15 K to 328.15 K) at atmospheric pressure. A quadratic mixing rule was used to correlate the ternary liquid densities. The Eyring–Patel–Teja model with two Margules-type mixing rules for polar and aqueous systems is used to correlate the dynamic viscosity data over the measured ternary compositions and temperatures. An excellent agreement with experimental data is obtained. Additionally, the predictive ASOG-VISCO model demonstrated a good representation of the experimental dat

Pilot plant validation of a rate-based extractive distillation model for water-ethanol separation with the ionic liquid [emim][DCA] as solvent

The separation of water–ethanol mixtures is an important research topic due to the use of ethanol as a replacement of fossil fuels. Extractive distillation with ionic liquids has been proposed as a promising and attractive technology to separate this mixture. However, ionic liquids show high viscositites and this could markedly decrease the mass transfer efficiency of the column. A rate based-model is able to predict and evaluate mass transfer efficiencies while only knowing the physical and transport properties of the system in question. With the objective of validating a developed rate-based model for the separation of water–ethanol mixtures by using 1-ethyl-3-methylimidazolium dicyanamide and ethylene glycol as solvents and investigating the effect of the solvent physical properties on mass transfer efficiency, an extractive distillation pilot-plant equipped with Mellapak® 750Y was constructed and operated in continuous mode. It was found that the rate-based model predicts the performance of this pilot plan very well for all the studied conditions within a 10% relative error. Slightly more optimistic water contents of the distillate stream were predicted and experimentally the ionic liquid produced lower water contents than ethylene glycol. The use of this ionic liquid provides higher mass transfer efficiencies for all the studied solvent-to-feed ratios. Finally, increasing the solvent-to-feed ratio enhances the mass transfer efficiencies for both solvents and effects of liquid viscosity decreasing the mass transfer efficiency are observed in the rectifying section of the extractive distillation colum

Experimental densities, dynamic viscosities and surface tensions of the ionic liquids series 1-ethyl-3-methylimidazolium acetate and dicyanamide and their binary and ternary mixtures with water and ethanol at T = (298.15 to 343.15 K)

In this paper, experimental densities and dynamic viscosities of 1-ethyl-3-methylimidazolium based ionic liquids (ILs) with the anions acetate and dicyanamide are presented in a wide temperature range (298.15 to 343.15 K) at atmospheric pressure. Surface tension of these ILs was measured at T = 298.15 K. The effect of water and/or ethanol compositions on densities and dynamic viscosities of these ILs are studied in binary and ternary mixtures. A quadratic mixing rule was used to correlate binary and ternary liquid densities. The Eyring–Patel–Teja model, which is recommended for polar and aqueous systems, is used to correlate dynamic viscosity data over the whole range of compositions and temperatures in binary and ternary mixtures. Temperature-dependent interaction parameters are introduced here to account for the changes of viscosities with temperature showing good agreements with experimental data

Ionic liquid screening of Octachlorodibenzo-p-dioxin captured from water samples by σ-profile analysis for microextraction applications

The extraction of octachlorodibenzo-p-dioxin (OCDD) is very challenging due to its highly non-polar nature, demanding the use of large amounts of toxic solvents. Ionic Liquids (ILs) for OCDD extraction were screened to replace traditional solvents using the Conductor-like Screening MOdel for Real Solvents (COSMO-RS). The analysis was performed by studying the �-profile of a variety of commercially available cations and anions employed in the literature. The effects of different alkyl chain lengths and configurations were studied in cations. In the case of anions, different reported structures, including fluorine- or oxygen-bearing structures, were assessed. Results indicate that the alkyl chain, symmetry, and nature of the central atom in the cations are critical factors to achieve high affinity to OCDD. The polarity of anions was found to be modified by adding highly electronegative atoms, a steric hindrance to the central atom and the use of planar geometries with symmetrical groups. The performance of ILs for extracting OCDD was compared with that of conventional solvent extractants used for quantifying dioxins in the US EPA-1613 method. Finally, three cations and anions are proposed as candidates for dioxin extraction