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.
SARS-CoV-2 has been associated with an increased rate of venous thromboembolism in critically ill patients. Since surgical patients are already at higher risk of venous thromboembolism than general populations, this study aimed to determine if patients with peri-operative or prior SARS-CoV-2 were at further increased risk of venous thromboembolism. We conducted a planned sub-study and analysis from an international, multicentre, prospective cohort study of elective and emergency patients undergoing surgery during October 2020. Patients from all surgical specialties were included. The primary outcome measure was venous thromboembolism (pulmonary embolism or deep vein thrombosis) within 30 days of surgery. SARS-CoV-2 diagnosis was defined as peri-operative (7 days before to 30 days after surgery); recent (1-6 weeks before surgery); previous (≥7 weeks before surgery); or none. Information on prophylaxis regimens or pre-operative anti-coagulation for baseline comorbidities was not available. Postoperative venous thromboembolism rate was 0.5% (666/123,591) in patients without SARS-CoV-2; 2.2% (50/2317) in patients with peri-operative SARS-CoV-2; 1.6% (15/953) in patients with recent SARS-CoV-2; and 1.0% (11/1148) in patients with previous SARS-CoV-2. After adjustment for confounding factors, patients with peri-operative (adjusted odds ratio 1.5 (95%CI 1.1-2.0)) and recent SARS-CoV-2 (1.9 (95%CI 1.2-3.3)) remained at higher risk of venous thromboembolism, with a borderline finding in previous SARS-CoV-2 (1.7 (95%CI 0.9-3.0)). Overall, venous thromboembolism was independently associated with 30-day mortality ). In patients with SARS-CoV-2, mortality without venous thromboembolism was 7.4% (319/4342) and with venous thromboembolism was 40.8% (31/76). Patients undergoing surgery with peri-operative or recent SARS-CoV-2 appear to be at increased risk of postoperative venous thromboembolism compared with patients with no history of SARS-CoV-2 infection. Optimal venous thromboembolism prophylaxis and treatment are unknown in this cohort of patients, and these data should be interpreted accordingly.
Road transportation is the backbone of modern economies, albeit it annually costs 1.25 million deaths and trillions of dollars to the global economy, and damages public health and the environment. Deep learning is among the leading-edge methods used for transportation-related predictions, however, the existing works are in their infancy, and fall short in multiple respects, including the use of datasets with limited sizes and scopes, and insufficient depth of the deep learning studies. This paper provides a novel and comprehensive approach toward large-scale, faster, and real-time traffic prediction by bringing four complementary cutting-edge technologies together: big data, deep learning, in-memory computing, and Graphics Processing Units (GPUs). We trained deep networks using over 11 years of data provided by the California Department of Transportation (Caltrans), the largest dataset that has been used in deep learning studies. Several combinations of the input attributes of the data along with various network configurations of the deep learning models were investigated for training and prediction purposes. The use of the pre-trained model for real-time prediction was explored. The paper contributes novel deep learning models, algorithms, implementation, analytics methodology, and software tool for smart cities, big data, high performance computing, and their convergence.
Restriction in nutrient acquisition is one of the primary causes for reduced growth and yield in water deficient soils. Sulfur (S) is an important secondary macronutrient that interacts with several stress metabolites to improve performance of food crops under various environmental stresses including drought. Increased S supply influences uptake and distribution of essential nutrients to confer nutritional homeostasis in plants exposed to limited water conditions. The regulation of S metabolism in plants, resulting in synthesis of numerous S-containing compounds, is crucial to the acclimation response to drought stress. Two different experiments were laid out in semi-controlled conditions to investigate the effects of different S sources on physiological and biochemical mechanisms of maize (Zea mays L. cv. P1574). Initially, the rate of S application in maize was optimized in terms of improved biomass and nutrient uptake. The maize seedlings were grown in sandy loam soil fertigated with various doses (0, 15, 30 and 45 kg ha −1) of different S fertilizers viz. K 2 So 4 , feSo 4 , cuSo 4 and na 2 So 4. The optimized S dose of each fertilizer was later tested in second experiment to determine its role in improving drought tolerance of maize plants. A marked effect of S fertilization was observed on biomass accumulation and nutrients uptake in maize. In addition, the optimized doses significantly increased the gas exchange characteristics and activity of antioxidant enzymes to improve yield of maize. Among various S sources, application of K 2 So 4 resulted in maximum photosynthetic rate (43%), stomatal conductance (98%), transpiration rate (61%) and sub-stomatal conductance (127%) compared to no S supply. Moreover, it also increased catalase, guaiacol peroxidase and superoxide dismutase activities by 55, 87 and 65%, respectively that ultimately improved maize yield by 33% with respect to control under water deficit conditions. These results highlight the importance of S fertilizers that would likely be helpful for farmers to get better yield in water deficient soils. Maize (Zea mays L.) is one of the major cereal crops that provide food for humans and feed for livestock. The demand for maize seed has increased significantly during past few decades due to its consumption in poultry feed and wet milling industry. The importance of maize as a food crop is well recognized and is used as a staple food in many parts of the world 1. Maize seed is an abundant source of energy as 100 g seed provides 365 kilocalories of energy 2. However, it is an extensive nutrient crop and excessive use of fertilizers to obtain high yield has resulted in the depletion of nutrients particularly sulfur (S) in soils 3. Moreover, water shortage due to climate change may induce further losses in maize production in future. Adaptation of maize to limited water conditions has received great interest from farmers, researchers and policy makers considering its importance in nutritional food security. Since maize requires large quantities of water to...
Rapid transit systems or metros are a popular choice for high-capacity public transport in urban areas due to several advantages including safety, dependability, speed, cost, and lower risk of accidents. Existing studies on metros have not considered appropriate holistic urban transport models and integrated use of cutting-edge technologies. This paper proposes a comprehensive approach toward large-scale and faster prediction of metro system characteristics by employing the integration of four leading-edge technologies: big data, deep learning, in-memory computing, and Graphics Processing Units (GPUs). Using London Metro as a case study, and the Rolling Origin and Destination Survey (RODS) (real) dataset, we predict the number of passengers for six time intervals (a) using various access transport modes to reach the train stations (buses, walking, etc.); (b) using various egress modes to travel from the metro station to their next points of interest (PoIs); (c) traveling between different origin-destination (OD) pairs of stations; and (d) against the distance between the OD stations. The prediction allows better spatiotemporal planning of the whole urban transport system, including the metro subsystem, and its various access and egress modes. The paper contributes novel deep learning models, algorithms, implementation, analytics methodology, and software tool for analysis of metro systems.
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