27 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

    Preparation of breathable polyurethane membranes with quaternary ammonium salt diols providing durable antibacterial property

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    Aim of this study was to produce hydrophilic breathable polyurethane membranes providing antibacterial property permanently by incorporation of a quaternary ammonium salt diol (QAS). The study was carried out by synthesis of nine different polyurethanes by solution polymerization through variations of their QAS and isocyanate contents. Fully amorphous membranes at a thickness of 30m were produced from the synthesized polymers and their thermal and morphological characteristics were determined. The effect of morphological structures on the membrane water vapor transmission rates (WVTR) and antibacterial properties were correlated. The WVTR increased with the increased temperature in all membranes over 10-40 degrees C, all produced membranes showed water resistance up to a pressure of 2100 cmH2O and WVTR values above 60g/m(2) h at 30 degrees C. The WVTR increased by increasing amount of QAS including cationic groups and decreased by increasing isocyanate amount reducing the molecular chain flexibility. In addition, while the unmodified membranes did not show any antibacterial activity, the QAS-added membranes provided significant inactivation against Staphylococcus aureus and Escherichia coli of about 104CFU within 5h of contact time

    A Practical Cost Model for Selecting Nonwoven Insulation Materials

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    ABSTRACT Elementary heat transfer in the range of density, thickness, and temperature normally used for house insulation, has been described experimentally for nonwoven structures. A model relating cost, density, and thermal efficiency of nonwoven insulating materials has been developed to aid in insulation materials selection and optimization of cost. Intrinsic to this system are material specific thermal conductivity slope coefficients readily derived from thermal conductivity versus specific volume plots. INTRODUCTION Thermal insulation materials are found in many structures from residential housing to space craft. In all applications, the purpose of a thermal insulator is to abate thermal transfer, precluding heat applied to one of its surfaces from escaping beyond other surface

    N-Halamine-coated cotton for antimicrobial and detoxification applications

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    A new N-halamine precursor, 3-(2,3-dihydroxypropyl)-7,7,9,9-tetramethyl- 1,3,8-triazaspiro[4.5]decane-2,4-dione (TTDD diol), was synthesized and bonded onto cotton fabrics. Fabrics with variable amounts of chlorine loading were prepared by using several concentrations of TTDD diol. A second N-halamine precursor, 3-(3-triethoxysilylpropyl)-7,7,9,9-tetramethyl-1,3,8-triazaspiro[4.5]decane-2,4-dione (TTDD siloxane), was also synthesized and bound to cotton for comparison purposes. The coated cotton fabrics contained two types of N-Cl moieties after chlorination of the amine and amide groups. Swatches with variable chlorine loadings were challenged with Staphylococcus aureus and Escherichia coli O157:H7 as a function of contact time. The biocidal test results showed that the chlorine loadings and surface hydrophobicities influenced the antimicrobial efficacies. The chlorinated swatches have also been employed to oxidize the simulant of chemical mustard to the less toxic sulfoxide derivative
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