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

Arredi e rivestimenti marmorei dallo scavo di via D’Azeglio a Ravenna: risultati preliminari

Lo scavo archeologico di via d’Azeglio a Ravenna, realizzato tra il 1993 e il 1994 sotto la direzione della Soprintendenza per i Beni Archeologici dell’Emilia Romagna (ora Soprintendenza Archeologia dell’Emilia Romagna), ha portato alla luce un ampio complesso residenziale che ha restituito una fitta sequenza stratigrafica articolata dall’età repubblicana al periodo altomedievale, che permette di restituire uno spaccato della storia urbana di un quartiere residenziale prospiciente un cardo stradale. Il contributo si inserisce all’interno del progetto di studio del complesso archeologico in collaborazione con il Dipartimento di Storia, Culture e Civiltà dell’Università di Bologna, finalizzato all’edizione integrale dei contesti di scavo e della cultura materiale da essi restituita. In questa sede verranno presentati i risultati preliminari relativi all’analisi effettuata su un campione di materiali pertinente gli arredi e i rivestimenti marmorei degli edifici indagati. La documentazione viene contestualizzata nell’ambito delle specifiche fasi insediative, al fine di ricostruire gli apparati decorativi dei vari ambienti e di fornire elementi utili per la cronologia delle diverse fasi edilizie e per la definizione degli aspetti funzionali, sociali e culturali del complesso

Ricerche sui materiali marmorei e lapidei di et\ue0 tardoantica a Ravenna

Between the end of the 5th and the end of the 6th centuries, over 1500 tonnes of marble were brought from Constantinople to Ravenna for the construction of its churches: if we consider that all the elements of liturgical furniture (ambos, parapets, fences, wall and floor covering slabs) and the large number of sarcophagi are excluded by this calculation, in scale this figure corresponds to a very considerable trade. According to a tradition of studies already rooted in the Department of History and Cultures of the University of Bologna, in 2013 a multidisciplinary and comprehensive review of the sculptures of Ravenna (4th-7th c.) was undertaken in a Mediterranean perspective

Spectral shaping of femtosecond pulses in aperiodic quasi-phase-matched gratings

We analyze the use of cascading second harmonic interactions in quadratic nonlinear crystals to mould the spectral characteristics of broadband near-infrared femtosecond pulses. Using a genetic algorithm, we optimize the design of the aperiodically poled ferroelectric crystal capable of generating the desired femtosecond infrared pulsed radiation

On a Fast Solution Strategy for a Surface-Wire Integral Formulation of the Anisotropic Forward Problem in Electroencephalography

This work focuses on a quasi-linear-in-complexity strategy for a hybrid surface-wire integral equation solver for the electroencephalography forward problem. The scheme exploits a block diagonally dominant structure of the wire self block -- that models the neuronal fibers self interactions -- and of the surface self block -- modeling interface potentials. This structure leads to two Neumann iteration schemes further accelerated with adaptive integral methods. The resulting algorithm is linear up to logarithmic factors. Numerical results confirm the performance of the method in biomedically relevant scenarios

GPS-navigator: an advanced search engine to gather information and navigate through standards in the field of geometrical product specification

The Geometrical Product Specification (GPS) and the Geometrical Dimensioning and Tolerancing (GD&T) are communication languages to code the tolerable morphology of manufactured parts and assemblies. Both languages should be unambiguous tools to communicate such information between designers, process engineers, and Coordinate Measuring Machines operators (CMM). GPS is the one developed in the ISO (International Organization for Standardization) environment. GPS language is a complex code of 143 standard with further 15 under development. Moreover, as in each complex body of standards, most of them recalls other standards in a very intricate manner. So, the need to have a flexible tool to search and navigate through the standards is great, as is the need to optimize the work of the designer and to minimize the design, production, and control costs. The basic effort in building such a tool has been the development of the database and the structure for the search engine, called "GPS Navigator". In the following, the requirements for the coding phase have also been issued, to realize a powerful, efficient, fast, robust, and rigorous tool to navigate through the GPS standards. The final step of the "GPS-Navigator project" is the delivery of a software tool able to help and guide the designer to quickly consult the appropriate standard or set of standards