Population issues and social indicators of well-being

Relating demographers' measures of various population characteristics (size, growth/decline, density, age/sex structures, migration, et cetera) to measures of well-being recently developed within the social indicators movement promises to provide new knowledge about the linkage of population and well-being that can enhance decision making about important population issues.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/43515/1/11111_2005_Article_BF01363887.pd

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

Distribution of ion-implanted yttrium in Cr sub 2 O sub 3 scale and in the underlying Ni-25 wt % Cr alloy

Implantation of yttrium and other reactive metals has been known to show significant effects on the oxidation behavior of Cr{sub 2}O{sub 3}-forming alloys. The oxide growth rate decreases by nearly a factor of ten, and the adhesion of oxide scales to alloys is greatly improved. To better understand the mechanisms by which these elements affect oxidation, it is important to know whether or not they are present in the metal ahead of the oxide layer. In this study, the diffusivity of implanted yttrium in a Ni-25 wt %Cr alloy and its distribution in the oxide scale after different oxidation times have been evaluated using secondary ion mass spectroscopy. It was found that only 17 ppm of yttrium was left in the alloy after just 20 minutes of oxidation at 1000{degrees}C. The implanted Y remained concentrated at the oxide/gas interface as the oxide thickened with time. Within the oxide layer, the Y concentration progressively dropped to zero at the scale/alloy interface. These results are discussed in relation to several important mechanisms proposed for the beneficial effects of reactive element additions on scale adhesion. 17 refs., 5 figs