28 research outputs found

    Enumerative Sphere Shaping for Rate Adaptation and Reach Increase in WDM Transmission Systems

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    The performance of enumerative sphere shaping (ESS), constant composition distribution matching (CCDM), and uniform signalling are compared at the same forward error correction rate. ESS is shown to offer a reach increase of approximately 10% and 22% compared to CCDM and uniform signalling, respectively.Comment: 4 Pages, 4 figure

    Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study

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    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.

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    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

    Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

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    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

    Enumerative sphere shaping for wireless communications with short packets

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    Probabilistic amplitude shaping (PAS) combines an outer shaping layer with an inner, systematic forward error correction (FEC) layer to close the shaping gap. Proposed for PAS, constant composition distribution matching (CCDM) produces amplitude sequences with a fixed empirical distribution. We show that CCDM suffers from high rate losses for small block lengths, and we propose to use Enumerative Sphere Shaping (ESS) instead. ESS minimizes the rate loss at any block length. Furthermore, we discuss the computational complexity of ESS and demonstrate that it is significantly smaller than shell mapping (SM), which is another method to perform sphere shaping. We then study the choice of design parameters for PAS. Following Wachsmann et al., we show that for a given constellation and target rate, there is an optimum balance between the FEC code rate and the entropy of the Maxwell-Boltzmann distribution that minimizes the gap-to-capacity. Moreover, we demonstrate how to utilize the non-systematic convolutional code from IEEE 802.11 in PAS. Simulations over the additive white Gaussian noise (AWGN) and frequency-selective channels exhibit that ESS is up to 1.6 and 0.7 dB more energy-efficient than uniform signaling at block lengths as small as 96 symbols, respectively, with convolutional and low-density parity-check (LDPC) codes

    Enumerative sphere shaping for wireless communications with short packets

    No full text
    Probabilistic amplitude shaping (PAS) combines an outer shaping layer with an inner, systematic forward error correction (FEC) layer to close the shaping gap. Proposed for PAS, constant composition distribution matching (CCDM) produces amplitude sequences with a fixed empirical distribution. We show that CCDM suffers from high rate losses for small block lengths, and we propose to use Enumerative Sphere Shaping (ESS) instead. ESS minimizes the rate loss at any block length. Furthermore, we discuss the computational complexity of ESS and demonstrate that it is significantly smaller than shell mapping (SM), which is another method to perform sphere shaping. We then study the choice of design parameters for PAS. Following Wachsmann et al., we show that for a given constellation and target rate, there is an optimum balance between the FEC code rate and the entropy of the Maxwell-Boltzmann distribution that minimizes the gap-to-capacity. Moreover, we demonstrate how to utilize the non-systematic convolutional code from IEEE 802.11 in PAS. Simulations over the additive white Gaussian noise (AWGN) and frequency-selective channels exhibit that ESS is up to 1.6 and 0.7 dB more energy-efficient than uniform signaling at block lengths as small as 96 symbols, respectively, with convolutional and low-density parity-check (LDPC) codes

    Partial enumerative sphere shaping

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    The dependency between the Gaussianity of the input distribution for the additive white Gaussian noise (AWGN) channel and the gap-to-capacity is discussed. We show that a set of particular approximations to the Maxwell- Boltzmann (MB) distribution virtually closes most of the shaping gap. We relate these symbol-level distributions to bit-level distributions, and demonstrate that they correspond to keeping some of the amplitude bit-levels uniform and independent of the others. Then we propose partial enumerative sphere shaping (P-ESS) to realize such distributions in the probabilistic amplitude shaping (PAS) framework. Simulations over the AWGN channel exhibit that shaping 2 amplitude bits of 16-ASK have almost the same performance as shaping 3 bits, which is 1.3 dB more power- efficient than uniform signaling at a rate of 3 bit/symbol. In this way, required storage and computational complexity of shaping are reduced by factors of 6 and 3, respectively.</p
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