The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AIM: The SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery. METHODS: This was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin. RESULTS: Overall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P < 0.001). After adjustment, delay was not associated with a lower rate of complete resection (OR 1.18, 95% CI 0.90-1.55, P = 0.224), which was consistent in elective patients only (OR 0.94, 95% CI 0.69-1.27, P = 0.672). Longer delays were not associated with poorer outcomes. CONCLUSION: One in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease

The Brazilian Soil Spectral Library (BSSL): A general view, application and challenges

Made available in DSpace on 2019-10-06T16:42:11Z (GMT). No. of bitstreams: 0 Previous issue date: 2019-11-15Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)The present study was developed in a joint partnership with the Brazilian pedometrics community to standardize and evaluate spectra within the 350–2500 nm range of Brazilian soils. The Brazilian Soil Spectral Library (BSSL) began in 1995, creating a protocol to gather soil samples from different locations in Brazil. The BSSL reached 39,284 soil samples from 65 contributors representing 41 institutions from all 26 states. Through the BSSL spectra database, it was possible to estimate important soil attributes, such as clay, sand, soil organic carbon, cation exchange capacity, pH and base saturation, resulting in differences among the multi-scale models taking Brazil (overall), regional and state scale. In general, spectral descriptive and quantitative behavior indicated important relationship with physical, chemical and mineralogical properties. Statistical analyses showed that six basic patterns of spectral signatures represent the Brazilian soils types and that environmental conditions explain the differences in spectra. This study demonstrates that spectroscopy analyses along with the establishment of soil spectral libraries are a powerful technique for providing information on a national and regional levels. We also developed an interactive online platform showing soil sample locations and their contributors. As soil spectroscopy is considered a fast, simple, accurate and nondestructive analytical procedure, its application may be integrated with wet analysis as an alternative to support the sustainable management of soils.Department of Soil Science Luiz de Queiroz College of Agriculture (ESALQ) University of São Paulo (USP), Ave. Pádua Dias 11, Cx. Postal 9Department of Soil Federal University of Santa Maria, Av. Roraima 1000Geographical Sciences Department Federal University of Pernambuco, Av. Ac. Hélio Ramos, s/nDepartment of Agronomy State University of Maringá, Av. Colombo 5790Department of Agriculture Biodiversity and Forestry Federal University of Santa Catarina, Rodovia Ulysses Gaboardi 3000 - Km 3Federal Rural University of Amazon, Ave. Presidente Tancredo Neves 2501Faculty of Agronomy and Veterinary Medicine University of BrasíliaEMBRAPA - Solos, R. Antônio Falcão, 402, Boa ViagemCenter of Nuclear Energy in Agriculture (CENA) USP, Av. Centenário 303CDRS/Secretary of Agriculture of São Paulo State, R. Campos Salles 507Department of Soils Federal University of Viçosa, Ave. Peter Henry Rolfs s/nEMBRAPA – Informática Agropecuária, Ave. André Tosello, 209Department of Nuclear Energy Federal University of Pernambuco, Av. Prof. Luis Freire 1000Department of Geography Federal University of Rio Grande do Norte, R. Joaquim Gregório s/nAgronomic Institute of Campinas (IAC), Ave. Barão de Itapura 1481Institute of Agricultural Sciences Federal Rural University of Amazônia, Ave. Presidente Tancredo Neves 2501, 66.077-830Department of Soil Science Federal University of LavrasFederal University of Mato Grosso, Cuiabá, Av. Fernando Corrêa da Costa 2367Department of Soils Federal Rural University of Rio de Janeiro, Rodovia BR 465, Km 07 s/nSoil and Water Sciences Department University of Florida, 2181 McCarty Hallr, PO Box 110290EMBRAPA - Solos, R. Jardim Botânico, 1024Department of Soils and Fertilizers School of Agricultural and Veterinary Studies São Paulo State University (FCAV-UNESP), Via de Acesso Prof. Paulo Donato Castellane s/nFederal University of Sergipe, Av. Marechal Rondon s/nGraduate Program in Earth Sciences (Geochemistry) Department of Geochemistry Federal Fluminense University, Outeiro São João Batista, s/nFederal Institute of the Southeast of Minas Gerais, R. Monsenhor José Augusto 204Federal University of Rio Grande do Norte, R. Joaquim Gregório s/nFederal University of PiauíEMBRAPA Milho e Sorgo, Rod MG 424 Km 45Institute of Agricultural Sciences Federal University of Jequitinhonha e Mucuri Valleys, Ave. Ver. João Narciso 1380Department of Biosystems Engineering ESALQ USP, Ave. Pádua Dias 11, Cx. Postal 9Federal University of Acre, Rodovia BR 364 Km 04Federal University of Amazonas, Av. General Rodrigo O. J. Ramos 1200EMBRAPA Clima Temperado, BR-392, km 78Department of Agronomy Federal Rural University of Pernambuco, R. Manuel de Medeiros s/nEMBRAPA Cocais, Quadra 11, Av. São Luís Rei de França 4Paraense Emílio Goeldi Museum, Av. Gov. Magalhães Barata 376Exata Laboratory, Rua Silvestre Carvalho Q 11Federal University of Rondônia, BR 364, Km 9.5Nacional Institute for Amazonian Research, Ave. André Araújo 2936Department of Forestry Sciences ESALQ-USP, Ave. Pádua Dias 11, Cx. Postal 9Department of Soils and Fertilizers School of Agricultural and Veterinary Studies São Paulo State University (FCAV-UNESP), Via de Acesso Prof. Paulo Donato Castellane s/nFAPESP: 2014/22262-0FAPESP: 2016/26176-6FAPESP: 2017/03207-

A review identifying the effectiveness of minimum quantity lubrication (MQL) during conventional machining

Government legislation and public opinion are the main drivers behind the movement of manufacturing companies towards sustainable production. Fundamentally, companies want to avoid future financial penalties and the industry is therefore under pressure to adapt new techniques and practices in order to become environmentally friendly. The cost efficiency of metal cutting operations is highly dependent on accuracy, excellent surface finish and minimized tool wear and, to this end, has traditionally made abundant use of cutting fluid in machining operations. However, these cutting fluids have been a major contributor to environmental and health issues. In recent years, an enormous effort to eradicate these adverse effects has been made with one important focus being the implementation of minimum quantity lubrication (MQL). In the present work, the authors have reviewed the current state of the art in MQL with a particular focus on drilling, turning, milling and grinding machining operations. Overall, it is concluded that MQL has huge potential as a substitute for conventional flood cooling

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

The SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery

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

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Preoperative nasopharyngeal swab testing and postoperative pulmonary complications in patients undergoing elective surgery during the SARS-CoV-2 pandemic.

BACKGROUND: Surgical services are preparing to scale up in areas affected by COVID-19. This study aimed to evaluate the association between preoperative SARS-CoV-2 testing and postoperative pulmonary complications in patients undergoing elective cancer surgery. METHODS: This international cohort study included adult patients undergoing elective surgery for cancer in areas affected by SARS-CoV-2 up to 19 April 2020. Patients suspected of SARS-CoV-2 infection before operation were excluded. The primary outcome measure was postoperative pulmonary complications at 30 days after surgery. Preoperative testing strategies were adjusted for confounding using mixed-effects models. RESULTS: Of 8784 patients (432 hospitals, 53 countries), 2303 patients (26.2 per cent) underwent preoperative testing: 1458 (16.6 per cent) had a swab test, 521 (5.9 per cent) CT only, and 324 (3.7 per cent) swab and CT. Pulmonary complications occurred in 3.9 per cent, whereas SARS-CoV-2 infection was confirmed in 2.6 per cent. After risk adjustment, having at least one negative preoperative nasopharyngeal swab test (adjusted odds ratio 0.68, 95 per cent confidence interval 0.68 to 0.98; P = 0.040) was associated with a lower rate of pulmonary complications. Swab testing was beneficial before major surgery and in areas with a high 14-day SARS-CoV-2 case notification rate, but not before minor surgery or in low-risk areas. To prevent one pulmonary complication, the number needed to swab test before major or minor surgery was 18 and 48 respectively in high-risk areas, and 73 and 387 in low-risk areas. CONCLUSION: Preoperative nasopharyngeal swab testing was beneficial before major surgery and in high SARS-CoV-2 risk areas. There was no proven benefit of swab testing before minor surgery in low-risk areas