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

L'insegnamento della chiesa ortodossa russa sulla dignità, libertà e i diritti dell'uomo

Kein Abstract verfügbarNo abstract availabl

European Integration and Russian Orthodoxy: Two multiple modernities perspectives

This article introduces a distinction in the paradigm of multiple modernities between a comparative-civilizational and a post-secular perspective. It argues that the first, comparative-civilizational perspective, helps to understand modernization-processes in large cultural-civilizational units; whereas the second, post-secular viewpoint, focuses on actors and cultural domains within civilizational units and on inter-civilizational crossovers. The two perspectives are complementary. What we gain from this distinction is greater precision in the use of multiple modernities for explaining the place of religion in modern societies. The example of Russian Orthodoxy is used for clarifying the difference between these two perspectives: whereas from a comparative-civilizational viewpoint, Russian Orthodoxy may appear as Europe’s ‘other’; from a post-secular viewpoint, Orthodox religion is part of Europe’s religious pluralist landscape and partakes in an ongoing process of defining the meaning of European political and cultural integration

Database and programs for study of the self similar properties of avalanche statistics in a simple turbulent model

This repository contains the computer code, the data and the plotting scripts for the study of the self similar properties of avalanche statistics in a simple turbulent model

Database and programs for study of the self similar properties of avalanche statistics in a simple turbulent model

This repository contains the computer code, the data and the plotting scripts for the study of the self similar properties of avalanche statistics in a simple turbulent model

Supplementary material from "A multi-component lattice Boltzmann approach to study the causality of plastic events"

Using a multi-component lattice Boltzmann (LB) model, we perform fluid kinetic simulations of confined and concentrated emulsions. The system presents the phenomenology of soft-glassy materials, including a Herschel–Bulkley rheology, yield stress, ageing and long relaxation time scales. Shearing the emulsion in a Couette cell below the yield stress results in plastic topological re-arrangement events which follow established empirical seismic statistical scaling laws, making this system a good candidate to study the physics of earthquakes. One characteristic of this model is the tendency for events to occur in avalanche clusters, with larger events, triggering subsequent re-arrangements. While seismologists have developed statistical tools to study correlations between events, a process to confirm causality remains elusive. We present here, a modification to our LB model, involving small, fast vibrations applied to individual droplets, effectively a macroscopic forcing, which results in the arrest of the topological plastic re-arrangements. This technique provides an excellent tool for identifying causality in plastic event clusters by examining the evolution of the dynamics after ‘stopping’ an event, and then checking which subsequent events disappear.This article is part of the theme issue ‘Fluid dynamics, soft matter and complex systems: recent results and new methods’