Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

Design of the ECCE Detector for the Electron Ion Collider

Preprint submitted to Nuclear Instruments and Methods A. The file archived on this institutional repository has not been certified by peer review.32 pages, 29 figures, 9 tablesThe EIC Comprehensive Chromodynamics Experiment (ECCE) detector has been designed to address the full scope of the proposed Electron Ion Collider (EIC) physics program as presented by the National Academy of Science and provide a deeper understanding of the quark-gluon structure of matter. To accomplish this, the ECCE detector offers nearly acceptance and energy coverage along with excellent tracking and particle identification. The ECCE detector was designed to be built within the budget envelope set out by the EIC project while simultaneously managing cost and schedule risks. This detector concept has been selected to be the basis for the EIC project detector.Office of Science in the Department of Energy, the National Science Foundation, and the Los Alamos National Laboratory Laboratory Directed Research and Development (LDRD) 20200022DR; This research used resources of the Compute and Data Environment for Science (CADES) at the Oak Ridge National Laboratory, which is supported by the Office of Science of the U.S. Department of Energy under Contract No. DE-AC05- 00OR22725. The work of AANL group are supported by the Science Committee of RA, in the frames of the research project # 21AG-1C028. And we gratefully acknowledge that support of Brookhaven National Lab and the Thomas Jefferson National Accelerator Facility which are operated under contracts DESC0012704 and DE-AC05-06OR23177 respectivel

AI-assisted optimization of the ECCE tracking system at the Electron Ion Collider

arXiv preprint [v2] Fri, 20 May 2022 03:23:44 UTC (2,296 KB) made available under a Creative Commons (CC BY) Attribution Licence, now in press, published by Elsevier: Nuclear Instruments and Methods in Physics Research Section A: Accelerators, Spectrometers, Detectors and Associated Equipment, available online 17 November 2022 at: https://doi.org/10.1016/j.nima.2022.167748The Electron-Ion Collider (EIC) is a cutting-edge accelerator facility that will study the nature of the "glue" that binds the building blocks of the visible matter in the universe. The proposed experiment will be realized at Brookhaven National Laboratory in approximately 10 years from now, with detector design and R&D currently ongoing. Notably, EIC is one of the first large-scale facilities to leverage Artificial Intelligence (AI) already starting from the design and R&D phases. The EIC Comprehensive Chromodynamics Experiment (ECCE) is a consortium that proposed a detector design based on a 1.5T solenoid. The EIC detector proposal review concluded that the ECCE design will serve as the reference design for an EIC detector. Herein we describe a comprehensive optimization of the ECCE tracker using AI. The work required a complex parametrization of the simulated detector system. Our approach dealt with an optimization problem in a multidimensional design space driven by multiple objectives that encode the detector performance, while satisfying several mechanical constraints. We describe our strategy and show results obtained for the ECCE tracking system. The AI-assisted design is agnostic to the simulation framework and can be extended to other sub-detectors or to a system of sub-detectors to further optimize the performance of the EIC detector.Office of Nuclear Physics in the Office of Science in the Department of Energy; National Science Foundation, and the Los Alamos National Laboratory Laboratory Directed Research and Development (LDRD) 20200022DR

Ensino de educação nos cursos de graduação em enfermagem Enseñanza de educación en los cursos de grado en enfermería Teaching of education in undergraduate nursing courses

O estudo analisou a produção bibliográfica sobre a temática educação em saúde e as repercussões sobre o ensino na graduação em enfermagem. Utilizou-se descritores selecionados nas bases LILACS, PERIENF e BDENF. Classificou-se as referências em quatro categorias: ensino, assistência, produção científica e acadêmica stricto sensu. Os resultados revelaram: a importância da temática educativa na prática social da enfermagem, para o que se evidencia não só a preocupação com a formação do educando, mas inclusive a do docente; apesar do esforço na graduação para o preparo do enfermeiro para as ações educativas, este é avaliado como inadequado; as práticas educativas, tanto em estudos classificados na categoria ensino quanto na assistencial, se mostraram referenciados na abordagem biomédica, com enfoque nos aspectos preventivos.<br>Este estudio analizó la producción bibliográfica sobre la temática educación en salud y las repercusiones sobre la enseñanza en graduación en enfermería. Los descriptores utilizados fueron seleccionados en las bases LILACS, PERIENF y BDENF. Las referencias fueron clasificadas en cuatro categorías: enseñanza, asistencia, producción científica y académica stricto sensu. Los resultados revelaron: la importancia de la temática educativa en la práctica social de enfermería, para lo que se evidencia no solo la preocupación con la formación del educando, mas inclusive la del docente; a pesar del esfuerzo en la graduación para la preparación del enfermero para las acciones educativas, ese es evaluado como inadecuado; las prácticas educativas, tanto en estudios de la categoría enseñanza cuanto de la asistencial, se mostraron referenciadas en el abordaje biomédico cuyo enfoque son los aspectos preventivos.<br>This study reviewed the literature on the health education subject and the impact on education in undergraduate nursing. Descriptors were selected in LILACS, PERIENF and BDENF bases. References were classified into four categories: education, care, scientific production and stricto sensu academic production. The results showed: the importance of educational issues in the nursing social practice, for what there is concern with the student and the teacher education; in spite of the effort in the undergraduation to prepare nurses for the educative actions, this is considered insufficient; the educative practices, in both teaching and care categories, are based on the biomedical model, with focus on preventive aspects