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Cardiac surgical mortality has significantly reduced in the last 15 years despite older and sicker patients. EuroSCORE II is better calibrated than the original model yet preserves powerful discrimination. It is proposed for the future assessment of cardiac surgical risk.

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Peri-operative SARS-CoV-2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS-CoV-2 infection. This international, multicentre, prospective cohort study included patients undergoing elective or emergency surgery during October 2020. Surgical patients with pre-operative SARS-CoV-2 infection were compared with those without previous SARS-CoV-2 infection. The primary outcome measure was 30-day postoperative mortality. Logistic regression models were used to calculate adjusted 30-day mortality rates stratified by time from diagnosis of SARS-CoV-2 infection to surgery. Among 140,231 patients (116 countries), 3127 patients (2.2%) had a pre-operative SARS-CoV-2 diagnosis. Adjusted 30-day mortality in patients without SARS-CoV-2 infection was 1.5% (95%CI 1.4-1.5). In patients with a pre-operative SARS-CoV-2 diagnosis, mortality was increased in patients having surgery within 0-2 weeks, 3-4 weeks and 5-6 weeks of the diagnosis (odds ratio (95%CI) 4.1 (3.3-4.8), 3.9 (2.6-5.1) and 3.6 (2.0-5.2), respectively). Surgery performed ≥ 7 weeks after SARS-CoV-2 diagnosis was associated with a similar mortality risk to baseline (odds ratio (95%CI) 1.5 (0.9-2.1)). After a ≥ 7 week delay in undertaking surgery following SARS-CoV-2 infection, patients with ongoing symptoms had a higher mortality than patients whose symptoms had resolved or who had been asymptomatic (6.0% (95%CI 3.2-8.7) vs. 2.4% (95%CI 1.4-3.4) vs. 1.3% (95%CI 0.6-2.0), respectively). Where possible, surgery should be delayed for at least 7 weeks following SARS-CoV-2 infection. Patients with ongoing symptoms ≥ 7 weeks from diagnosis may benefit from further delay.

JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, and build upon a wide range of content in a trusted digital archive. We use information technology and tools to increase productivity and facilitate new forms of scholarship. For more information about JSTOR, please contact support@jstor.org.. Ecological Society of America is collaborating with JSTOR to digitize, preserve and extend access to Ecology.Abstract. Granivores are likely to store food in numerous, widely scattered, small caches if they are unable to defend concentrated large caches against interspecific competitors. This scatterhoarding of seeds makes it impossible for individuals to defend all their scattered caches against intraspecific competitors as well. Optimal spacing of scattered caches should result from a balance between de? creasing loss of caches to naive competitors with decreasing density and increasing cost of storage with decreasing density. A mathematical model predicting optimal density is presented.One prediction of the model is that as the are (0} of habitat suitable for seed burial surrounding a seed source is decreased, the average distance (D) a cache is taken from the source by scatterhoarders should increase. Another prediction is that increasing the number of seeds (N) at a source, either by an increase in the size of a single seed crop or by the_presence of 2 or more conspecific seed producers in close proximity to one another, shouldmcrease D. One trait of trees which increases single crop sizes and average seed dispersal distance (D) is the pattern of withholding energy from reproduction some years to allow unusually large crops during mast years.Three field tests of the model and its predictions were conducted: (1) Juglans nigra seeds were buried at 3 densities and their survival in time from predation by Sciurus niger was found to increase with decreasing density; (2) average distances that J. nigra saplings occurred from 16 parent walnut trees were found to have a statistically significant correlation with the D calculated from the model and the 6 of suitable habitat surrounding each tree; (3) Sciurus niger individuals were observed to scatterhoard Juglans nigra seeds in a pattern that maintained a mean cache density that gives low rates of loss to naive competitors as indicated from field test (1). The results strongly suggest maintenace of optimum cache density by S. niger. The coevolution of trees which have mast years and the animals that scatterhoard their seeds is discussed. nprvnl mnHeP vnuirre]' ut/ilnutdispersal model: squirrel: walnut enough to make whole cones an ineffective source of seeds for mice, and the chipmunks that can open cones 1 Manuscript received 26 September 1977; accepted 15 February 1978. are driven away from larders for the short period be? fore chipmunks enter hibernation (Smith 1968). The system of individual, intrageneric territories effectively defends an individual's source of cones and its larder from its 1 source of competition, other individ...

JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, and build upon a wide range of content in a trusted digital archive. We use information technology and tools to increase productivity and facilitate new forms of scholarship. For more information about JSTOR, please contact support@jstor.org.. Ecological Society of America is collaborating with JSTOR to digitize, preserve and extend access to Ecological Monographs.

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