Correction to: Two years later: Is the SARS-CoV-2 pandemic still having an impact on emergency surgery? An international cross-sectional survey among WSES members

Background: The SARS-CoV-2 pandemic is still ongoing and a major challenge for health care services worldwide. In the first WSES COVID-19 emergency surgery survey, a strong negative impact on emergency surgery (ES) had been described already early in the pandemic situation. However, the knowledge is limited about current effects of the pandemic on patient flow through emergency rooms, daily routine and decision making in ES as well as their changes over time during the last two pandemic years. This second WSES COVID-19 emergency surgery survey investigates the impact of the SARS-CoV-2 pandemic on ES during the course of the pandemic. Methods: A web survey had been distributed to medical specialists in ES during a four-week period from January 2022, investigating the impact of the pandemic on patients and septic diseases both requiring ES, structural problems due to the pandemic and time-to-intervention in ES routine. Results: 367 collaborators from 59 countries responded to the survey. The majority indicated that the pandemic still significantly impacts on treatment and outcome of surgical emergency patients (83.1% and 78.5%, respectively). As reasons, the collaborators reported decreased case load in ES (44.7%), but patients presenting with more prolonged and severe diseases, especially concerning perforated appendicitis (62.1%) and diverticulitis (57.5%). Otherwise, approximately 50% of the participants still observe a delay in time-to-intervention in ES compared with the situation before the pandemic. Relevant causes leading to enlarged time-to-intervention in ES during the pandemic are persistent problems with in-hospital logistics, lacks in medical staff as well as operating room and intensive care capacities during the pandemic. This leads not only to the need for triage or transferring of ES patients to other hospitals, reported by 64.0% and 48.8% of the collaborators, respectively, but also to paradigm shifts in treatment modalities to non-operative approaches reported by 67.3% of the participants, especially in uncomplicated appendicitis, cholecystitis and multiple-recurrent diverticulitis. Conclusions: The SARS-CoV-2 pandemic still significantly impacts on care and outcome of patients in ES. Well-known problems with in-hospital logistics are not sufficiently resolved by now; however, medical staff shortages and reduced capacities have been dramatically aggravated over last two pandemic years

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

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

A new comprehensive model of damage for flexural subassemblies prone to fatigue

Fatigue resistance is a key performance for the life-cycle sustainability of materials and structures. Structural members subjected to flexural forces such as spring hinges in origami structures are one of the most commonly existing in nature and engineering practice but predicting their fatigue resistance is a challenge because of complex mechanisms of crack localization, nonstationary amplitudes in the time domain, and the influence of stress gradient due to bending moment. We developed a general lumped damage simulation model for predicting the fatigue life and the associated crack propagation in the full range of elastic and plastic amplitudes. It is found that the developed comprehensive damage model demonstrates a new perspective for fatigue-induced remaining life quantification for engineering structures. (c) 2021 Elsevier Ltd. All rights reserved

Damage Evolution Modeling for Steel Structures Subjected to Combined High Cycle Fatigue and High-Intensity Dynamic Loadings

This paper presents a method for modeling the initiation and propagation of the damage in steel structures under combined fatigue loading. An existing model in the literature is used as the main key to the development of the new formulation herein proposed, where a significant computational improvement for the cracking incubation phase under high cycle fatigue (HCF) is achieved. The results show a satisfactory comparison with experimental data available in the literature and the carried parametric simulations demonstrate the effectiveness of the model once strength reduction could be estimated after 0, 20, 40, and 60 years of HCF. The reduction of the structural capacity was evaluated by the consideration of the final damage due to a high-intensity dynamic loading at the end of the HCF phase

ATLANTIC MAMMAL TRAITS: a data set of morphological traits of mammals in the Atlantic Forest of South America

Univ Estadual Paulista, UNESP, Dept Ecol, Inst Biociencias, BR-13506900 Rio Claro, SP, BrazilUniv Fed Santa Catarina, Ctr Ciencias Biol, Dept Ecol & Zool, Florianopolis, SC, Brazil|Caipora Cooperat, Florianopolis, SC, BrazilUniv Estadual Santa Cruz, Programa Posgrad Ecol & Conservac Biodiversidade, Lab Ecol Aplicada Conservacao, Ilheus, BA, BrazilUniv Estadual Santa Cruz, CMARF, Ilheus, BA, BrazilUniv Brasilia, Dept Ecol, Inst Ciencias Biol, Lab Ecol Vertebrados, Brasilia, DF, BrazilUniv Fed Santa Maria, Dept Ecol & Evolut, Santa Maria, RS, BrazilUniv Sao Paulo, Inst Biociencias, Dept Zool, Sao Paulo, SP, BrazilUniv Fed Espirito Santo, Ctr Ciencias Humanas & Nat, Dept Ciencias Biol, Vitoria, ES, BrazilUniv Fed Minas Gerais, Inst Ciencias Biol, Dept Biol Geral, Belo Horizonte, MG, BrazilUniv Fed Mato Grosso de Sul, Inst Biociencias, Campo Grande, MS, BrazilUniv Fed Parana, Dept Zool, Curitiba, Parana, BrazilUniv Fed Parana, Programa Posgrad Ecol & Conservcao, Curitiba, Parana, BrazilUniv Estado Rio de Janeiro, Dept Ecol, Rio De Janeiro, RJ, BrazilUniv Estadual Paulista, UNESP, Inst Biociencias, Dept Zool, Rio Claro, SP, BrazilUniv Extremo Sul Catarinense, Programa Posgrad Ciencias Ambientais, Criciuma, SC, BrazilUniv Sao Paulo, ESALQ, Dept Ciencias Biol, Piracicaba, SP, BrazilUniv Nacl Misiones, CONICET, Inst Biol Subtrop, Puerto Iguazu, Misiones, ArgentinaAsociac Civil Ctr Invest Bosque Atlantico, Puerto Iguazu, Misiones, ArgentinaFIOCRUZ Amazonas, Inst Leonidas & Maria Deane, Manaus, Amazonas, BrazilUniv Estadual Paulista, UNESP, Dept Zootecnia, Jaboticabal, SP, BrazilField Museum Nat Hist, Integrated Res Ctr, Chicago, IL 60605 USAUniv Fed Pernambuco, Ctr Biociencias, Dept Zool, Lab Ciencia Aplicada Conservacao Biodiversidade, Recife, PE, BrazilInst Chico Mendes Conservacao Biodiversidade, Ctr Nacl Pesquisa & Conservacao Mamiferos Carnivo, Sao Paulo, BrazilUniv Vale Rio dos Sinos, Sao Leopoldo, RS, BrazilUniv Reg Cariri, Dept Biol, Lab Ecol Mamiferos, Crato, CE, BrazilUniv Fed Rio de Janeiro, Dept Ecol, Lab Vertebrados, Rio De Janeiro, RJ, BrazilUniv Federal Mato Grosso do Sul, Programa Posgrad Ecol & Conservacao, Campo Grande, MS, BrazilIPE, Nazare Paulista, SP, BrazilUniv Fed Minas Gerais, Programa Posgrad Zool, Belo Horizonte, MG, BrazilUniv Estado Minas Gerais, Dept Ciencias Biol, Ibirite, MG, BrazilPREA, Programa Educ Ambiental, Juiz De Fora, MG, BrazilChinese Acad Sci, Inst Zool, Key Lab Zool Systemat and Evolut, Beijing, Peoples R ChinaMinist Salud Nacion, Inst Nacl Med Trop INMeT, Puerto Iguazu, Misiones, ArgentinaUniv Fed Vicosa, Dept Engn Florestal, Vicosa, MG, BrazilUniv Fed Goias, Inst Biociencias, Jatai, Go, BrazilInst Chico Mendes Conservacao Biodiversidade ICMB, Ctr Nacl Pesquisa & Conservacao Primatas Brasilei, Joao Pessoa, PB, BrazilCtr Rescate Fauna Silvestre Guira Oga, Puerto Iguazu, ArgentinaFdn Hist Nat Felix de Azara, Buenos Aires, ArgentinaProjeto Carnivoros Iguacu, Foz Do Iguacu, PR, BrazilUniv Estadual Paulista, Dept Med Vet Prevent & Reprod Anim, Fac Ciencias Agr & Vet Jaboticabal, Jaboticabal, SP, BrazilUniv Fed Integracao Latinoamer, Inst Latinoamer Ciencias Vida & Nat, Foz Do Iguacu, PR, BrazilUniv Fed Sao Paulo, Dept Ciencias Ambientais, Diadema, SP, BrazilUniv Fed Paraiba, Dept Sistemat & Ecol, Lab Mamiferos, Joao Pessoa, Paraiba, BrazilIUCN Peccary Specialist Grp, Campo Grande, MS, BrazilWWF Brazil, Campo Grande, MS, BrazilChicago State Univ, Dept Biol Sci, Chicago, IL USAUniv Fed Rio de Janeiro, Nucleo Ecol & Desenvolvimento Socioambiental Maca, Macae, RJ, BrazilUniv Vila Velha, Programa Posgrad Ecol Ecossistemas, Vila Velha, ES, BrazilUniv Fed Rio de Janeiro, Museu Nacl, Dept Vertebrados, Rio De Janeiro, RJ, BrazilUniv Fed Bahia, Programa Posgrad Ecol, Salvador, BA, BrazilUniv Fed Paraiba, Dept Sistemat & Ecol, Programa Posgrad Ciencias Biol Zool, Lab Mamiferos, Joao Pessoa, Paraiba, BrazilUniv Fed Sao Paulo, Dept Ciencias Ambientais, Diadema, SP, BrazilWeb of Scienc