Variation in postoperative outcomes of patients with intracranial tumors: insights from a prospective international cohort study during the COVID-19 pandemic

Background: This study assessed the international variation in surgical neuro-oncology practice and 30-day outcomes of patients who had surgery for an intracranial tumor during the COVID-19 pandemic. Methods: We prospectively included adults aged ≥18 years who underwent surgery for a malignant or benign intracranial tumor across 55 international hospitals from 26 countries. Each participating hospital recorded cases for 3 consecutive months from the start of the pandemic. We categorized patients’ location by World Bank income groups (high [HIC], upper-middle [UMIC], and low- and lower-middle [LLMIC]). Main outcomes were a change from routine management, SARS-CoV-2 infection, and 30-day mortality. We used a Bayesian multilevel logistic regression stratified by hospitals and adjusted for key confounders to estimate the association between income groups and mortality. Results: Among 1016 patients, the number of patients in each income group was 765 (75.3%) in HIC, 142 (14.0%) in UMIC, and 109 (10.7%) in LLMIC. The management of 200 (19.8%) patients changed from usual care, most commonly delayed surgery. Within 30 days after surgery, 14 (1.4%) patients had a COVID-19 diagnosis and 39 (3.8%) patients died. In the multivariable model, LLMIC was associated with increased mortality (odds ratio 2.83, 95% credible interval 1.37–5.74) compared to HIC. Conclusions: The first wave of the pandemic had a significant impact on surgical decision-making. While the incidence of SARS-CoV-2 infection within 30 days after surgery was low, there was a disparity in mortality between countries and this warrants further examination to identify any modifiable factors

Etude vibrationnelle des monophosphates SrM2(PO4)2 avec M=Co, Ni

International audienceThe infrared and Raman spectra of triclinic phosphates SrM2(PO4)2 where M=Co, Ni have been reported and analysed. The results of a force field calculation for SrNi2(PO4)2 are presented.Ce travail porte sur l’étude expérimentale et théorique des spectres de vibration des phosphates SrM2(PO4)2 avec M=Ni, Co synthétisés par nous même. Une attribution des raies et des bandes de vibration a été proposée et confirmée par un calcul du champ de force du composé SrNi2(PO4)2

Digital Transformation in the Healthcare Sector: Empirical Evidences of IoHT Benefits and Limits on Chronic Disease Management

Drawing from DT and Healthcare literature, this paper analyses the impact of IoT on the healthcare sector (IoHT). Particularly it focuses on chronic diseases management, by finding main IoHT benefits and limits, specifically re- lated to such underexplored area. In order to ensure the consistency of findings, the paper relies on a pilot case study designed both on primary (interviews) and secondary (Hospitals manuals, books, procedures and guidelines) data. Results highlight that the use of IoHT is perceived to bring improvement in clinician ar- ea, patients’ quality of life and hospital cost rationalization. However, such achievements are perceived as not automatic, being related to different enabling conditions, which involve mainly technical and safety variables. From a theo- retical perspective, the paper contributes mainly to the Healthcare digital trans- formation literature, by offering new elements to foster the on­going debate about IoHT implementation, its benefits and limits. From an empirical perspec- tive, it provides healthcare practitioners with specific IoHT pilot case, cardiac- chronicity oriented, in order to effectively understand its real potentialities and threats. Moreover, the paper provides an original reading about technical and clinical aspects of IoHT through the managerial lens, necessary to organizations for the sustainability of healthcare service delivery