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- Khatri, C, et al.
(författare)
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Outcomes after perioperative SARS-CoV-2 infection in patients with proximal femoral fractures: an international cohort study
- 2021
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Ingår i: BMJ open. - : BMJ. - 2044-6055. ; 11:11, s. e050830-
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Tidskriftsartikel (refereegranskat)abstract
- Studies have demonstrated high rates of mortality in people with proximal femoral fracture and SARS-CoV-2, but there is limited published data on the factors that influence mortality for clinicians to make informed treatment decisions. This study aims to report the 30-day mortality associated with perioperative infection of patients undergoing surgery for proximal femoral fractures and to examine the factors that influence mortality in a multivariate analysis.SettingProspective, international, multicentre, observational cohort study.ParticipantsPatients undergoing any operation for a proximal femoral fracture from 1 February to 30 April 2020 and with perioperative SARS-CoV-2 infection (either 7 days prior or 30-day postoperative).Primary outcome30-day mortality. Multivariate modelling was performed to identify factors associated with 30-day mortality.ResultsThis study reports included 1063 patients from 174 hospitals in 19 countries. Overall 30-day mortality was 29.4% (313/1063). In an adjusted model, 30-day mortality was associated with male gender (OR 2.29, 95% CI 1.68 to 3.13, p<0.001), age >80 years (OR 1.60, 95% CI 1.1 to 2.31, p=0.013), preoperative diagnosis of dementia (OR 1.57, 95% CI 1.15 to 2.16, p=0.005), kidney disease (OR 1.73, 95% CI 1.18 to 2.55, p=0.005) and congestive heart failure (OR 1.62, 95% CI 1.06 to 2.48, p=0.025). Mortality at 30 days was lower in patients with a preoperative diagnosis of SARS-CoV-2 (OR 0.6, 95% CI 0.6 (0.42 to 0.85), p=0.004). There was no difference in mortality in patients with an increase to delay in surgery (p=0.220) or type of anaesthetic given (p=0.787).ConclusionsPatients undergoing surgery for a proximal femoral fracture with a perioperative infection of SARS-CoV-2 have a high rate of mortality. This study would support the need for providing these patients with individualised medical and anaesthetic care, including medical optimisation before theatre. Careful preoperative counselling is needed for those with a proximal femoral fracture and SARS-CoV-2, especially those in the highest risk groups.Trial registration numberNCT04323644
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| 2. |
- Moukaddam, M., et al.
(författare)
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In-beam internal conversion electron spectroscopy with the SPICE detector
- 2018
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Ingår i: Nuclear Instruments and Methods in Physics Research, Section A: Accelerators, Spectrometers, Detectors and Associated Equipment. - : Elsevier BV. - 0168-9002. ; 905, s. 180-187
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Tidskriftsartikel (refereegranskat)abstract
- The SPectrometer for Internal Conversion Electrons (SPICE) has been commissioned for use in conjunction with the TIGRESS γ-ray spectrometer at TRIUMF's ISAC-II facility. SPICE features a permanent rare-earth magnetic lens to collect and direct internal conversion electrons emitted from nuclear reactions to a thick, highly segmented, lithium-drifted silicon detector. This arrangement, combined with TIGRESS, enables in-beam γ-ray and internal conversion electron spectroscopy to be performed with stable and radioactive ion beams. Technical aspects of the device, capabilities, and initial performance are presented.
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| 3. |
- Bader, A., et al.
(författare)
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Energetic Particle Signatures Above Saturn's Aurorae
- 2020
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Ingår i: Journal of Geophysical Research - Space Physics. - 2169-9380 .- 2169-9402. ; 125:1
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Tidskriftsartikel (refereegranskat)abstract
- Near the end of its mission, NASA's Cassini spacecraft performed several low-altitude passes across Saturn's auroral region. We present ultraviolet auroral imagery and various coincident particle and field measurements of two such passes, providing important information about the structure and dynamics of Saturn's auroral acceleration region. In upward field-aligned current regions, upward proton beams are observed to reach energies of several tens of keV; the associated precipitating electron populations are found to have mean energies of about 10 keV. With no significant wave activity being apparent, these findings indicate strong parallel potentials responsible for auroral acceleration, about 100 times stronger than at Earth. This is further supported by observations of proton conics in downward field-aligned current regions above the acceleration region, which feature a lower energy cutoff above similar to 50 keV-indicating energetic proton populations trapped by strong parallel potentials while being transversely energized until they can overcome the trapping potential, likely through wave-particle interactions. A spacecraft pass through a downward current region at an altitude near the acceleration region reveals plasma wave features, which may be driving the transverse proton acceleration generating the conics. Overall, the signatures observed resemble those related to the terrestrial and Jovian aurorae, the particle energies and potentials at Saturn appearing to be significantly higher than at Earth and comparable to those at Jupiter. Plain Language Summary NASA's Cassini spacecraft orbited closer to Saturn than ever before during the last stage of its mission, the "Grand Finale". This allowed the onboard instruments to measure charged particles and plasma waves directly above the auroral region while simultaneously providing high-resolution imagery of the ultraviolet aurorae. Based on observations of highly energetic ions streaming away from the planet in regions of low plasma wave activity, we infer the existence of strong electric fields which act to accelerate electrons down into the atmosphere, driving the bright auroral emissions. Our estimates of the average energy of the precipitating electrons support this finding. Charged ions sometimes seem to be energized by plasma waves above the aurorae before they can escape, but the exact process in which this happens is not fully understood. Most signatures presented here resemble those observed in relation to Earth's aurorae, suggesting that the mechanisms acting at both planets are quite similar although Saturn's acceleration mechanism is significantly stronger.
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