Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

An ultra-wide bandwidth (704 to 4 032 MHz) receiver for the Parkes radio telescope

We describe an ultra-wide-bandwidth, low-frequency receiver recently installed on the Parkes radio telescope. The receiver system provides continuous frequency coverage from 704 to 4032 MHz. For much of the band ( ${∼}60$ ), the system temperature is approximately 22 K and the receiver system remains in a linear regime even in the presence of strong mobile phone transmissions. We discuss the scientific and technical aspects of the new receiver, including its astronomical objectives, as well as the feed, receiver, digitiser, and signal processor design. We describe the pipeline routines that form the archive-ready data products and how those data files can be accessed from the archives. The system performance is quantified, including the system noise and linearity, beam shape, antenna efficiency, polarisation calibration, and timing stability

A Study of Hybridization Understanding from Algorithmic to Conceptual – Is Algorithmic an End Point for Students?

This paper details the results of a qualitative study examining the reasoning students use to solve common hybridization theory assessment questions and their mental images of hybrid and atomic orbitals. The data were collected through think-aloud interviews as students worked through a five-question questionnaire. Prior to recruitment, the study was deemed to be exempt from IRB review by Sterling IRB. Prior to start of interviews participants provided verbal consent. The resulting transcripts and answers were analyzed following the practices of grounded theory and constant comparative analysis. Coding schemes can be found in the Supplementary Information section. Results, conclusions, and implications for teaching are presented in the manuscript.</p

Multipoint observations of Pc1-2 waves in the afternoon sector

Coordinated observations from GOES-9, DMSP F-13, and Chokurdakh (CHD) have shown concurrent Pc1-2 band wave activity in the late afternoon sector, close to 16 MLT. The left-hand polarization of the waves in space indicates that these are electromagnetic ion cyclotron (EMIC) waves. In the region of field line conjunction, DMSP also observed 6–30 keV energy ion precipitation. We have examined the propagation of the EMIC waves from the magnetosphere to the ionosphere using both time series analysis and a 2½D magnetohydrodynamic model. Our analysis suggests that the EMIC are generated by interactions with cold plasma within a drainage plume, consistent with theory, and that the waves primarily propagate earthward along geomagnetic field lines at the eastward (outer) edge of the plume