Timing of surgery following SARS-CoV-2 infection: an international prospective cohort study.

Peri-operative SARS-CoV-2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS-CoV-2 infection. This international, multicentre, prospective cohort study included patients undergoing elective or emergency surgery during October 2020. Surgical patients with pre-operative SARS-CoV-2 infection were compared with those without previous SARS-CoV-2 infection. The primary outcome measure was 30-day postoperative mortality. Logistic regression models were used to calculate adjusted 30-day mortality rates stratified by time from diagnosis of SARS-CoV-2 infection to surgery. Among 140,231 patients (116 countries), 3127 patients (2.2%) had a pre-operative SARS-CoV-2 diagnosis. Adjusted 30-day mortality in patients without SARS-CoV-2 infection was 1.5% (95%CI 1.4-1.5). In patients with a pre-operative SARS-CoV-2 diagnosis, mortality was increased in patients having surgery within 0-2 weeks, 3-4 weeks and 5-6 weeks of the diagnosis (odds ratio (95%CI) 4.1 (3.3-4.8), 3.9 (2.6-5.1) and 3.6 (2.0-5.2), respectively). Surgery performed ≥ 7 weeks after SARS-CoV-2 diagnosis was associated with a similar mortality risk to baseline (odds ratio (95%CI) 1.5 (0.9-2.1)). After a ≥ 7 week delay in undertaking surgery following SARS-CoV-2 infection, patients with ongoing symptoms had a higher mortality than patients whose symptoms had resolved or who had been asymptomatic (6.0% (95%CI 3.2-8.7) vs. 2.4% (95%CI 1.4-3.4) vs. 1.3% (95%CI 0.6-2.0), respectively). Where possible, surgery should be delayed for at least 7 weeks following SARS-CoV-2 infection. Patients with ongoing symptoms ≥ 7 weeks from diagnosis may benefit from further delay

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Towards deeper understanding of the acidity of graphene oxide: Influence of thermal treatments on his acid properties

SSCI-VIDE+CDFA+SKH:NESInternational audienceNon

Transesterification of a vegetal oil with methanol catalyzed by a silica fibre reinforced aerogel encapsulated lipase

International audienceA commercial lipase solution from Candida antartica, Lipozyme1, was encapsulated in silica aerogels reinforced with silica quartz fibre felt. This biocatalyst was applied in biodiesel synthesis by direct transesterification of sunflower seed oil with methanol, without any other solvent. With a molar ratio of methanol to oil of 1, the encapsulated enzyme achieved ~90% methanol conversion after 50 h at 40°C. The recycling activity increased by ~40% after the first test, then it slowly decreased in further tests to reach an activity still 20% higher than initially, during the fifth test. Textural and structural analysis of the aerogels before and after catalytic tests showed that this improvement was associated with a modification of the liquid medium inside the aerogel, by preferential adsorption of glycerol. The aerogel samples were also compared to a commercial CALB product immobilized on polymer beads with a different enzyme loading, from Fluka. This product showed a better activity during the first test but its activity decreased by 20% during a second test

Location-Aided Pilot Contamination Avoidance for Massive MIMO Systems

Pilot contamination, defined as the interference during the channel estimation process due to reusing the same pilot sequences in neighboring cells, can severely degrade the performance of massive multiple-input multiple-output systems. In this paper, we propose a location-based approach to mitigating the pilot contamination problem for uplink multiple-input multiple-output systems. Our approach makes use of the approximate locations of mobile devices to provide good estimates of the channel statistics between the mobile devices and their corresponding base stations. Specifically, we aim at avoiding pilot contamination even when the number of base station antennas is not very large, and when multiple users from different cells, or even in the same cell, are assigned the same pilot sequence. First, we characterize a desired angular region of the target user at the serving base station based on the number of base station antennas and the location of the target user, and make the observation that in this region the interference is close to zero due to the spatial separability. Second, based on this observation, we propose pilot coordination methods for multi-user multi-cell scenarios to avoid pilot contamination. The numerical results indicate that the proposed pilot contamination avoidance schemes enhance the quality of the channel estimation and thereby improve the per-cell sum rate offered by target base stations.Peer reviewe

Hybrid catalysis by coupling enzymatic catalysis with heterogeneous catalysis in cellulose conversion into chemicals

SSCI-VIDE+CDFA+ADN:LCH:NESNational audienceNon

Hybrid catalysis by coupling enzymatic catalysis with heterogeneous catalysis in cellulose conversion into chemicals

SSCI-VIDE+CDFA+ADN:LCH:NESNational audienceNon

Oral contraceptive pills shortage in Lebanon amidst the economic collapse: a nationwide exploratory study

Abstract Background The political instability, economic crisis, and devaluation of the national currency left Lebanese females suffering from a scarcity of oral contraceptive pills (OCPs). Therefore, we aimed to identify the incidence of OCPs shortage in Lebanon and its impact on women’s sexual and reproductive health, as well as physical and psychological well-being. Methods Community pharmacies were selected randomly across Lebanon, using a stratified sampling approach, where female clients asking for OCPs were interviewed using a standardized data collection form. Results A total of 440 females were interviewed. More than three-quarters of the participants (76.4%) reported not finding their preferred OCPs brands, almost 40% were affected by the increased prices, and 28.4% declared stockpiling OCPs. More than half of the participants using OCPs for pregnancy prevention reported adopting alternative traditional contraceptive methods (55.3%). Unplanned pregnancy was reported by 9.5% of participants, where 75% of them disclosed intentional abortion while the remaining (25%) reported experiencing a spontaneous miscarriage. Other consequences of OCPs shortage included mood disturbances (52.3%), dysregulation of menses (49.7%), dysmenorrhea (21.1%), weight gain (19.6%), acne (15.7%), and hirsutism (12.5%). Of the participants taking OCPs for birth control, 48.6% reported a reduced frequency of sexual intercourse, which led to conflicts with their partners (46%) and a decreased libido (26.7%). Conclusions OCPs shortage has seriously and negatively exposed women to various undesirable consequences including unplanned pregnancy and dysregulation of menses. Therefore, there is an urgent need to bring the attention of healthcare authorities to support the national pharmaceutical industry in manufacturing affordable OCPs generics to meet women’s reproductive health demands