Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

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

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

Expresión geomorfológica de la actividad reciente de la falla de Amer (NE de la Península Ibérica)

Triangular facets, related drainage basins, alluvial fans and subtle scarps reveal the recent activity of the normal Amer fault (NE Spain). The 1427 earthquakes which reached epicentral intensities ranging between VI1 and VI11 have been attributed to the Amer fault. However, the geomorphologic and geologic characteristics of this fault (30 km length) suggest that it might be capable of producing larger earthquakes than those occurred during de 15th century

Tectònica extensiva d'edat juràssica a l'illa de Cabrera (Balears)

Jurassic extensional tectonics caused the breakupof the liasic carbonate shelf and the deepening of thepelagic basin at Cabrera (Balearic Islands) duringDogger, Malm and Eearly Cretaceous. As a result ofthis extensional event we found an angular unconfor-mity of the pelagic rocks over the shelf carbonates,the presence of olistolites and olistostromes in thelower part of the pelagic sequence, and a synsedimen-tary system of conjugate normal faults

Evidencias de eventos cosísmicos recurrentes en el período prehistórico en la falla de Alhama de Murcia

[EN] The Alhama de Murcia fault is a 85 km long oblique-slip fault, and is related to historical and instrumental seismic activity. A paleoseismic analysis of the Lorca-Totana sector of the fault containing MSK I=VIII historical earthquakes was made in order to identify and quantify its seismic potential. We present 1) the results of the neotectonic, structural and geomorphological analyses and, 2) the results of trenching. In the study area, the Alhama de Murcia fault forms a depressed corridor between two strands, the northwestern fault with morphological and structural features of a reverse component of slip, bounding the La Tercia range to the South, and the southeastern fault strand with evidence of sinistral oblique strike-slip movement. The offset along this latter fault trapped the sediments in transit from the La Tercia range towards the Guadalentín depression. The most recent of these sediments are arranged in three generations of alluvial fans and terraces. The first two trenches were dug in the most recent sediments across the southeastern fault strand. The results indicate a coseismic reverse fault deformation that involved the sedimentary sequence up to the intermediate alluvial fan and the Holocene terrace deposits. The sedimentary evolution observed in the trenches suggests an event of temporary damming of the Colmenar creek drainage to the South due to uplifting of the hanging wall during coseismic activation of the fault. Trench, structural and sedimentological features provide evidence of at least three coseismic events, which occurred after 125,000 yr. The minimum vertical slip rate along the fault is 0.06 mm/yr and the average recurrence period should not exceed 40,000 yr in accordance with the results obtained by fan topographic profiling. Further absolute dating is ongoing to constrain these estimates.[ES] Se presentan los primeros resultados del estudio paleosísmico del sector Lorca-Totana (con terremotos históricos de I=VIII) de la falla de Alhama de Murcia, de deslizamiento direccional oblícuo sinestroso, para caracterizar su potencial sísmico. Esto incluye: 1) resultados del estudio neotectónico, estructural y geomorfológico y 2) primeros resultados obtenidos en trincheras. El área estudiada muestra dos zonas de falla, la noroeste, que limita la sierra de la Tercia, con morfología y estructuras típicas de movimiento inverso, y la sureste con evidencias de deslizamiento direccional sinestroso, separadas por un corredor deprimido. La actividad de estas fallas ha atrapado en el corredor gran cantidad de sedimentos en su transporte hacia la depresión del Guadalentín, los más recientes de los cuales se o rganizan en tres generaciones de abanicos aluviales y terrazas. Las dos trincheras se ex c avaron en los sedimentos de la generación int e rmedia de abanicos aluviales y en la de terrazas más recientes deformados por la falla sureste. Los primeros resultados indican deformación cosísmica con deslizamiento inverso. Se interpreta también un bloqueo temporal del drenaje hacia el sur de la rambla de El Colmenar debido al levantamiento del bloque superior de la falla en un proceso cosísmico. Se describen evidencias de hasta tres paleoterremotos que, en un primer análisis sin datos de edad absoluta, habrían tenido lugar posteriormente a 125.000 años. La velocidad de deslizamiento no sería inferior a 0,06 mm/a y el período de recurrencia no sería mayor a 40.000 años. Estos primeros datos se podrán ajustar mediante dataciones absolutas que están en curso.This study was supported by the FAUST project (ENV4- CT97-0528) and the project AMB97-0523: "Active tectonic analysis of the Murcia region and their application to seismic hazard assessment" (C.I.C.Y.T.). We are indebted to Daniela Pantosti and Hervé Philip for critically rev i ewing this paper. We also thank Mabel Gómez, Raquel Amores, Angel Martínez, Juan Arregui, and Juanmi Insua for their invaluable help. Thanks are also due to Mrs. Mª. Victoria Tejón for permission to trench on her property.Peer reviewe

Expresión geomorfológica de la actividad reciente de la falla de Amer (NE de la Península Ibérica)

Triangular facets, related drainage basins, alluvial fans and subtle scarps reveal the recent activity of the normal Amer fault (NE Spain). The 1427 earthquakes which reached epicentral intensities ranging between VI1 and VI11 have been attributed to the Amer fault. However, the geomorphologic and geologic characteristics of this fault (30 km length) suggest that it might be capable of producing larger earthquakes than those occurred during de 15th century

In Search of the Source of the 1865-1866 Nicaraguan Earthquakes: Paleoseismic Data from the Cofradia Fault, Managua Graben (Nicaragua)

In 1865-1866, a series of catastrophic earthquakes struck Managua, Nicaragua. We present new data supporting the view that these earthquakes were caused by the seismogenic Cofradia fault. The data were collected at three paleoseismological sites: La Vaqueria (central-northern area), El Cocal (central area), and Piedra Menuda (located at an antithetic strand of the southern fault segment). Coseismic evidence includes liquefaction features, offset layers, and colluvial wedges dated using radiocarbon ages and pottery fragments, providing relative cultural ages. The minimum event displacement observed at the central site (1 m) and the total length of the mapped geomorphological trace (39 km) are consistent with a maximum expected magnitude around 7. A minimum slip rate between 1.1 and 1.4 mm/yr is obtained from the new data, reinforcing earlier estimates. In line with paleoseismic chronology and compared with a Bayesian OxCal model of the stratigraphic sequence, at least three seismic events have occurred since A.D. 300, the last one occurring after A.D. 790 and the twentieth century. Thus, the earthquakes of 1865-1866 that resulted in surface alterations in the Tipitapa River probably correspond to the last paleoseismic event on the Cofradia fault. This assumption yields a range between 1511 and 1245 yr for the best estimated maximum recurrence interval between the ultimate and penultimate event

Paleoseismology along the Cofradía fault, Managua, Nicaragua: preliminary results

La falla de Cofradía es una falla normal de orientación N-S que limita por el E el graben de Managua y tiene una longitud de 40 km. Esta falla es sísmicamente activa y, a partir de datos históricos, a ella se han asociado los terremotos de 1865 y 1866 que cambiaron la topografía del río Tipitapa. Se ha llevado a cabo un estudio paleosismológico en su sector meridional mediante la apertura de 5 trincheras en tres localidades. En la trinchera de El Cocal se han identificado 3 eventos sísmicos. Actualmente no se dispone todavía de las dataciones con radiocarbono, pero la presencia de cerámica de los períodos Bagaces y Sapoá permite afirmar que estos eventos han ocurrido durante los últimos 1700 años, con un periodo de recurrencia del orden de 500 años, y deja abierta la posibilidad de que el último evento detectado corresponda a los terremotos de 1865 y 1866

Paleoseismology along the Cofradía fault, Managua, Nicaragua: preliminary results

La falla de Cofradía es una falla normal de orientación N-S que limita por el E el graben de Managua y tiene una longitud de 40 km. Esta falla es sísmicamente activa y, a partir de datos históricos, a ella se han asociado los terremotos de 1865 y 1866 que cambiaron la topografía del río Tipitapa. Se ha llevado a cabo un estudio paleosismológico en su sector meridional mediante la apertura de 5 trincheras en tres localidades. En la trinchera de El Cocal se han identificado 3 eventos sísmicos. Actualmente no se dispone todavía de las dataciones con radiocarbono, pero la presencia de cerámica de los períodos Bagaces y Sapoá permite afirmar que estos eventos han ocurrido durante los últimos 1700 años, con un periodo de recurrencia del orden de 500 años, y deja abierta la posibilidad de que el último evento detectado corresponda a los terremotos de 1865 y 1866