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1,403 results on '"Newton, N"'

9. In Memoriam: Abner J. Mikva (1926-2016)

Author

Adams, Kenneth L., Baird, Douglas G., Emmerich, Adam O., Kagan, Elena, Marco, Jack, Miller, Ronald S., Minow, Newton N., Stone, Geoffrey R., and Strauss, David A.

Published
2016

11. Considerations for collecting and analyzing longitudinal data in observational cohort studies of transgender, non-binary, and gender diverse people.

Author

Bailey, S., Newton, N., Perry, Y., Grummitt, L., Smout, S., and Barrett, E.

Subjects
*HEALTH services accessibility, *HEALTH status indicators, *DATA analysis, *GENDER identity, *DIVERSITY & inclusion policies, *TRANSGENDER people, *NONBINARY people, *MEDICAL research, *ACQUISITION of data, *EVIDENCE-based medicine, *PSYCHOSOCIAL factors, *WELL-being, *EPIDEMIOLOGICAL research
Abstract

The health and well-being of transgender, non-binary, and gender-diverse people is receiving increasing attention from epidemiologists and public health researchers, including those utilizing longitudinal observational cohort studies. These longitudinal studies are advantageous over cross-sectional observational study designs given their scope over several timepoints rather than one, and when exposures and outcomes are prospectively measured this improves validity of causal claims. However, within these longitudinal studies, gender is often collected inconsistently (e.g. only asked at a single timepoint), or inadequately (e.g. questions that use limiting notions of gender). Due to the temporal nature of gender, this introduces potential including misclassification error and may provide an incomplete picture of gender diversity in a sample. This article considers these methodological issues and offers evidence-based recommendations to ensure longitudinal data on trans, non-binary, and gender-diverse people is treated with epidemiological rigor, while maintaining inclusivity. [ABSTRACT FROM AUTHOR]

Published
2024
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13. It's past your bedtime, but does it matter anymore? How longitudinal changes in bedtime rules relate to adolescents' sleep

Author

Bauducco, Serena, Gardner, L. A., Champion, K., Newton, N., Gradisar, M., Bauducco, Serena, Gardner, L. A., Champion, K., Newton, N., and Gradisar, M.

Abstract

This study investigated how changing or maintaining parent-set bedtimes over time relates to adolescents' sleep timing, latency, and duration. Adolescents (n = 2509; Mage = 12.6 [0.5] years; 47% m) self-reported their sleep patterns, and whether they had parent-set bedtimes on two separate occasions in 2019 (T1; 12.6 years) and 2020 (T2; 13.7 years). We identified four groups based on parent-set bedtimes: (1) bedtime rules at both T1 and T2 (46%, n = 1155), (2) no bedtime rules at T1 nor T2 (26%, n = 656), (3) bedtime rules at T1 but not T2 (19%, n = 472), (4) no bedtime rules at T1 but a parent-set bedtime at T2 (9%, n = 226). As expected, the entire sample showed that bedtimes generally became later and sleep duration shorter across adolescence, but the change differed among the groups. Adolescents whose parents introduced bedtime rules at T2 reported earlier bedtimes and longer sleep duration (~20 min) compared with adolescents with no bedtime rules at T2. Importantly, they no longer differed from adolescents who consistently had bedtimes across T1 and T2. There was no significant interaction for sleep latency, which declined at a similar rate for all groups. These results are the first to suggest that maintaining or re-introducing a parent-set bedtime may be possible and beneficial for adolescents' sleep., Funding agencies:Paul Ramsay FoundationNational Health and Medical Research Council (NHMRC) of Australia APP1120641 APP1078407 APP1166377

Published
2024
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16. High-Conductivity Inserts Positioning Approach Using Constructal Theory and Agent-Based Modeling

Author

Avendaño, Paola A., Marube, Newton N., Adamatti, Diana F., Souza, Jeferson A., Hutchison, David, Series editor, Kanade, Takeo, Series editor, Kittler, Josef, Series editor, Kleinberg, Jon M., Series editor, Mattern, Friedemann, Series editor, Mitchell, John C., Series editor, Naor, Moni, Series editor, Pandu Rangan, C., Series editor, Steffen, Bernhard, Series editor, Terzopoulos, Demetri, Series editor, Tygar, Doug, Series editor, Weikum, Gerhard, Series editor, Nardin, Luis Gustavo, editor, and Antunes, Luis, editor

Published
2017
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18. It's past your bedtime, but does it matter anymore? How longitudinal changes in bedtime rules relate to adolescents' sleep.

Author

Bauducco, S. V., Gardner, L. A., Champion, K., Newton, N., and Gradisar, M.

Subjects
SLEEP latency, SLEEP duration, BEDTIME, SLEEP, TEENAGERS, TEENAGE girls, SLEEP hygiene
Abstract

Summary: This study investigated how changing or maintaining parent‐set bedtimes over time relates to adolescents' sleep timing, latency, and duration. Adolescents (n = 2509; Mage = 12.6 [0.5] years; 47% m) self‐reported their sleep patterns, and whether they had parent‐set bedtimes on two separate occasions in 2019 (T1; 12.6 years) and 2020 (T2; 13.7 years). We identified four groups based on parent‐set bedtimes: (1) bedtime rules at both T1 and T2 (46%, n = 1155), (2) no bedtime rules at T1 nor T2 (26%, n = 656), (3) bedtime rules at T1 but not T2 (19%, n = 472), (4) no bedtime rules at T1 but a parent‐set bedtime at T2 (9%, n = 226). As expected, the entire sample showed that bedtimes generally became later and sleep duration shorter across adolescence, but the change differed among the groups. Adolescents whose parents introduced bedtime rules at T2 reported earlier bedtimes and longer sleep duration (~20 min) compared with adolescents with no bedtime rules at T2. Importantly, they no longer differed from adolescents who consistently had bedtimes across T1 and T2. There was no significant interaction for sleep latency, which declined at a similar rate for all groups. These results are the first to suggest that maintaining or re‐introducing a parent‐set bedtime may be possible and beneficial for adolescents' sleep. [ABSTRACT FROM AUTHOR]

Published
2024
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19. Clinical characteristics of people with intellectual disability admitted to hospital with constipation: identifying possible specific high‐risk factors.

Author

Laugharne, R., Wilcock, M., Rees, J., Wainwright, D., Newton, N., Sterritt, J., Badger, S., Bishop, R., Bassett, P., and Shankar, R.

Subjects
CONSTIPATION -- Risk factors, CONSTIPATION, PATIENTS, PATIENTS' attitudes, HOSPITAL admission & discharge, RISK assessment, CONTENT mining, PUBLIC hospitals, DESCRIPTIVE statistics, INTELLECTUAL disabilities, LONGITUDINAL method, COMORBIDITY
Abstract

Background: People with intellectual disabilities (ID) die on an average 20 years earlier to the general population. They have higher rates of multimorbidity and polypharmacy. Around 25% of people with ID report chronic constipation. The England Learning Disabilities Mortality Review found that nearly 25% of deaths identified constipation as a long‐term health problem. However, the likely risk factors for constipation related harm are poorly enumerated. We sought to identify possible specific high‐risk factors by examining the clinical characteristics of people with ID admitted to hospital with constipation. Methods: Data of people with ID admitted with constipation in two general hospitals covering a population of 1.3 million from 2017 to 2022 were reported using the STROBE guideline for cohort studies. Collected data included age, gender, intellectual disability severity, recorded medication, presenting complaint and co‐morbidities. The medication anticholinergic burden was calculated using the anticholinergic burden scale. Continuous variables were summarised by mean and standard deviation if normally distributed, with categorical variables summarised by the number and percentage in each category. Results: Of 46 admissions (males 52%), 57% had moderate to profound ID, 37% had epilepsy, 41% prescribed antiseizure medication (ASM) and 45% were on laxatives. Average age was 46 years. The anticholinergic burden score mean was 2.3 and median, one. Conclusions: We can hypothesise that people with more severe ID, suffering from epilepsy and on ASM may be more at risk of developing severe constipation. Some admissions may be avoided with earlier use of laxatives in the community. [ABSTRACT FROM AUTHOR]

Published
2024
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23. Randomized Trial of Late Surfactant Treatment in Ventilated Preterm Infants Receiving Inhaled Nitric Oxide

Author

Strong, S. Hamilton, Immamura-Ching, J., Orfanos-Villalobos, M., Williams, C., Horton, D., Pacello, L., Willard, A., Gauldin, C., Holmes, A., Johnson, P., Meinert, K., Reynolds, A.M., Lucie, J., Conway, P., Sacilowski, M.l., Leadersdorff, M., Orbank, P., Wynn, K., deUngria, M., Khan, J., Hamann, K., Schau, M., Hopkins, B., Jenson, J., Garcia, C., Shariff, J., McGovern, R., Adelman, J., Combs, A., Tjersland, M., Walker, S., Howland, E., Longoria, J., Meo, H., McDavid, G., Burson, K., Hinojosa, R., Johnson, C., Miller, K., Rogers, S., Wright, S., Barnette, K., Kellum, A., Burke, M., Hayes, C., Chadwick, S., Howard, D., Kennedy, C., Prince, R., Stefanescu, B., Helderman, J., Warden, K., Brown, P., Griffin, J., Conley, L., Georgieff, M., Davern, B., Mills, M., Ritter, S., Wagner, C., Fanning, D., Roberson, J., Lampland, A., Meyers, P., Brey, A., Worwa, C., Dixon, P., Ebert, G., Hejl, C., Maxwell, M., McCullough, K., El Abiad, M.T., Talati, A., Dempsey, S., Gammage, K., Gower, G., James, K., LeNoue, P., Bell, S., Bruton, D., Beaulieu, M., Williams, R., Barron-Nelson, R., Taylor, S., Sikes, N.C., Lowe, G., Proffitt, B., Chapin, C., Horneman, H., Kelley, S., Vittinghoff, E., Hietpas, J., Denton, L., Wu, L., Jobe, A., Fanaroff, A., Clemons, T., Glantz, L., Reboussin, D., Van Meurs, K., Allen, M., Vohr, B., Ballard, R., Ballard, P., Blaisdell, C., Durand, D., Black, D., Eichenwald, E., Keller, R., Mammel, M., Merrill, J., Rogers, E., Ryan, R., Truog, W., Asselin, J., Newton, N., Ballard, Roberta A., Keller, Roberta L., Black, Dennis M., Ballard, Philip L., Merrill, Jeffrey D., Eichenwald, Eric C., Truog, William E., Mammel, Mark C., Steinhorn, Robin H., Rogers, Elizabeth E., Ryan, Rita M., Durand, David J., Asselin, Jeanette M., Bendel, Catherine M., Bendel-Stenzel, Ellen M., Courtney, Sherry E., Dhanireddy, Ramasubbareddy, Hudak, Mark L., Koch, Frances R., Mayock, Dennis E., McKay, Victor J., O'Shea, T. Michael, Porta, Nicolas F., Wadhawan, Rajan, and Palermo, Lisa

Published
2016
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24. Adolescents’ Mental Health Hrajectories throughout the COVID-19 Pandemic and the Protective role of Healthy Sleep Patterns

Author

Bauducco, Serena, Gardner, L, Newton, N, Gradisar, M, Smout, S, Chapman, C, Gamble, A, Teesson, M, Champion, K, Bauducco, Serena, Gardner, L, Newton, N, Gradisar, M, Smout, S, Chapman, C, Gamble, A, Teesson, M, and Champion, K

Abstract

Introduction: The COVID-19 pandemic has seen a rise in emotional problems among adolescents. Improving young people's mental health is a public health priority, and examining protective factors throughout the pandemic can offer insights on targets for prevention. This study aimed to investigate longitudinal trajectories of depressive and anxiety symptoms among a large sample of Australian adolescents and to examine sleep patterns in high- and low-risk trajectories. Methods: This study utilises data from the control group of the “Health4Life” cluster RCT. We used three waves of questionnaire data collected annually (from 2019) from Year 7 students at 71 secondary schools across New South Wales, Queensland and Western Australia (N = 2,781, Mage = 12.6, SD = .51; 47% boys and 1.4% ‘prefer not to say’). Adolescents reported on their mental health (i.e., depressive and anxiety symptoms) and sleep (i.e., sleepiness, weekday sleep duration, SOL, WASO, and chronotype). Results: We found four trajectories of depressive symptoms: low-stable (64.3%), average-increasing (19.2%), high-decreasing (7.1%), moderate-increasing (9.4%), and three anxiety symptom trajectories: low-stable (74.8%), average-increasing (11.6%), high-decreasing (13.6%). Adolescents in low-risk trajectories were more likely to be boys and to report shorter SOL and WASO, longer sleep duration, less sleepiness, and earlier chronotype. Where mental health waxed and waned, sleep patterns changed in the same direction. Discussion: This is the first study to thoroughly examine adolescents’ sleep patterns as a protective factor for the development of emotional problems during the pandemic. Healthy sleep was clearly linked to low-risk trajectories, although this association is likely bi-directional.

Published
2023
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25. Structure of Compound 13 bound to CK2alpha

Author

Brear, P., primary, Fusco, C., additional, Atkinson, E., additional, Iegre, J., additional, Francis-Newton, N., additional, Venkotaraman, A., additional, Spring, D., additional, and Hyvonen, M., additional

Published
2023
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27. Social Media, Distrust, and Regulation

Author

Newton N. Minow, Nell Minow, Martha Minow, and Mary Minow

Abstract

A guiding principle of regulation of communications in the United States has been the public interest, but what does the concept of the public interest mean today, a time when the sheer amount of misinformation can drown out accurate information? This essay, presented as a discussion, explores the problems of misinformation in the age of digital media. Though the authors do not agree on all elements of their proposed reforms, they propose ideas such as the articulation of a core set of journalistic principles for anything major media companies label “news”; increasing support for public libraries, media literacy education, and public media; establishing a nonprofit public internet; requiring large internet platforms, which arguably function like a public square, to publicize their community standards for removing content and to adopt policies to at least slow the distribution of content that incites imminent violence; and staying abreast of international ideas that might be of use in the United States.

Published
2022
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28. Structure of Compound 14 bound to CK2alpha

Author

Brear, P., primary, Fusco, C., additional, Atkinson, E., additional, Iegre, J., additional, Francis-Newton, N., additional, Venkotaraman, A., additional, Spring, D., additional, and Hyvonen, M., additional

Published
2022
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36. Abandoned in the Wasteland: Children, Television, and the First Amendment. First Edition.

Author

Minow, Newton N. and LaMay, Craig L.

Abstract

This book argues that it is time for Americans to rebuild their television system and that translating the public interest into a commitment to the nation's children will take time, education, and public debate. The book affirms that American adults need to consider what public interest means with respect to those who are too young to vote, who are barely literate, who are financially, emotionally, and even physically dependent on adults--children, in other words. Although the commercial interests dominating television today argue that the Constitution gives them the right to broadcast whatever they wish, the book points out that this is a false application of the First Amendment. The book also points out that broadcasters are required by law to serve the public interest, and that the Supreme Court and Congress regard service to children as a broadcaster's obligation under law. The book argues that the First Amendment can be used on behalf of children, to help make television a force that will nurture and not harm them. It offers many workable ideas for an effective children's television policy (America is alone among the Western democracies in not yet having one) and for new ways to ensure that the nation's children travel safely on the information superhighway. Appendixes contain "A Bill for Children's Telecommunications" and "The Wasteland Speeches, 1961 and 1991." (NKA)

Published
1995

39. Molecular Characterization and Survive Abilities of Salmonella Heidelberg Strains of Poultry Origin in Brazil

Author

Bertram Brenig, Micaela Guidotti-Takeuchi, Newton N Galvão, Belchiolina Beatriz Fonseca, Rodrigo Profeta, Guilherme Paz Monteiro, Roberta Torres de Melo, Vasco Azevedo, Phelipe Augusto Borba Martins Peres, and Daise Aparecida Rossi

Subjects
Microbiology (medical), salmonellosis, Tetracycline, Virulence, Biology, Microbiology, 03 medical and health sciences, Antibiotic resistance, medicine, Cefoxitin, antimicrobial resistance, 030304 developmental biology, 2. Zero hunger, 0303 health sciences, whole genome sequencing, 030306 microbiology, Biofilm, biochemical phenomena, metabolism, and nutrition, biology.organism_classification, QR1-502, 3. Good health, Penicillin, virulence, Colistin, biofilms, Bacteria, medicine.drug
Abstract

The aim of the study was to evaluate the genotypic and phenotypic characteristics of 20 strains of S. Heidelberg (SH) isolated from broilers produced in southern Brazil. The similarity and presence of genetic determinants linked to virulence, antimicrobial resistance, biofilm formation, and in silico-predicted metabolic interactions revealed this serovar as a threat to public health. The presence of the ompC, invA, sodC, avrA, lpfA, and agfA genes was detected in 100% of the strains and the luxS gene in 70% of them. None of the strains carries the blaSHV, mcr-1, qnrA, qnrB, and qnrS genes. All strains showed a multidrug-resistant profile to at least three non-β-lactam drugs, which include colistin, sulfamethoxazole, and tetracycline. Resistance to penicillin, ceftriaxone (90%), meropenem (25%), and cefoxitin (25%) were associated with the presence of blaCTX–M and blaCMY–2 genes. Biofilm formation reached a mature stage at 25 and 37°C, especially with chicken juice (CJ) addition. The sodium hypochlorite 1% was the least efficient in controlling the sessile cells. Genomic analysis of two strains identified more than 100 virulence genes and the presence of resistance to 24 classes of antibiotics correlated to phenotypic tests. Protein-protein interaction (PPI) prediction shows two metabolic pathways correlation with biofilm formation. Virulence, resistance, and biofilm determinants must be constant monitoring in SH, due to the possibility of occurring infections extremely difficult to cure and due risk of the maintenance of the bacterium in production environments.

Published
2021
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49. Molecular Characterization and Survive Abilities of

Author

Roberta T, Melo, Newton N, Galvão, Micaela, Guidotti-Takeuchi, Phelipe A B M, Peres, Belchiolina B, Fonseca, Rodrigo, Profeta, Vasco A C, Azevedo, Guilherme P, Monteiro, Bertram, Brenig, and Daise A, Rossi

Subjects
virulence, whole genome sequencing, salmonellosis, antimicrobial resistance, biochemical phenomena, metabolism, and nutrition, biofilms, Microbiology, Original Research
Abstract

The aim of the study was to evaluate the genotypic and phenotypic characteristics of 20 strains of S. Heidelberg (SH) isolated from broilers produced in southern Brazil. The similarity and presence of genetic determinants linked to virulence, antimicrobial resistance, biofilm formation, and in silico-predicted metabolic interactions revealed this serovar as a threat to public health. The presence of the ompC, invA, sodC, avrA, lpfA, and agfA genes was detected in 100% of the strains and the luxS gene in 70% of them. None of the strains carries the blaSHV, mcr-1, qnrA, qnrB, and qnrS genes. All strains showed a multidrug-resistant profile to at least three non-β-lactam drugs, which include colistin, sulfamethoxazole, and tetracycline. Resistance to penicillin, ceftriaxone (90%), meropenem (25%), and cefoxitin (25%) were associated with the presence of blaCTX–M and blaCMY–2 genes. Biofilm formation reached a mature stage at 25 and 37°C, especially with chicken juice (CJ) addition. The sodium hypochlorite 1% was the least efficient in controlling the sessile cells. Genomic analysis of two strains identified more than 100 virulence genes and the presence of resistance to 24 classes of antibiotics correlated to phenotypic tests. Protein-protein interaction (PPI) prediction shows two metabolic pathways correlation with biofilm formation. Virulence, resistance, and biofilm determinants must be constant monitoring in SH, due to the possibility of occurring infections extremely difficult to cure and due risk of the maintenance of the bacterium in production environments.

Published
2021

50. Elective cancer surgery in COVID-19–Free surgical pathways during the SARS-cov-2 pandemic: An international, multicenter, comparative cohort study

Author

James C Glasbey, Dmitri Nepogodiev, Joana Ff Simoes, Omar Omar, Elizabeth Li, Mary L Venn, Mohammad Abou Chaar, Vita Capizzi, Daoud Chaudhry, Anant Desai, Jonathan G Edwards, Jonathan P Evans, Marco Fiore, Jose Flavio Videria, Samuel J Ford, Ian Ganyli, Ewen A Griffiths, Rohan R Gujjuri, Angelos G Kolias, Haytham Ma Kaafarani, Ana Minaya-Bravo, Siobhan C McKay, Helen M Mohan, Keith Roberts, Carlos San Miguel-Méndez, Peter Pockney, Richard Shaw, Neil J Smart, Grant D Stewart, Sudha Sundar, Raghavan Vidya, Aneel A Bhangu, James C Glasbey, Omar Omar, Aneel A Bhangu, Kwabena Siaw-Acheampong, Ruth A Benson, Edward Bywater, Daoud Chaudhry, Brett E Dawson, Jonathan P Evans, James C Glasbey, Rohan R Gujjuri, Emily Heritage, Conor S Jones, Sivesh K Kamarajah, Chetan Khatri, Rachel A Khaw, James M Keatley, Andrew Knight, Samuel Lawday, Elizabeth Li, Harvinder S Mann, Ella J Marson, Kenneth A McLean, Siobhan C McKay, Emily C Mills, Dmitri Nepogodiev, Gianluca Pellino, Maria Picciochi, Elliott H Taylor, Abhinav Tiwari, Joana Ff Simoes, Isobel M Trout, Mary L Venn, Richard Jw Wilkin, Aneel A Bhangu, James C Glasbey, Neil J Smart, Ana Minaya-Bravo, Jonathan P Evans, Gaetano Gallo, Susan Moug, Francesco Pata, Peter Pockney, Salomone Di Saverio, Abigail Vallance, Dale Vimalchandran, Ewen A Griffiths, Sivesh K Kamarajah, Richard Pt Evans, Philip Townend, Keith Roberts, Siobhan McKay, John Isaac, Sohei Satoi, John Edwards, Aman S Coonar, Adrian Marchbank, Edward J Caruana, Georgia R Layton, Akshay Patel, Alessandro Brunelli, Samuel Ford, Anant Desai, Alessandro Gronchi, Marco Fiore, Max Almond, Fabio Tirotta, Sinziana Dumitra, Angelos Kolias, Stephen J Price, Daniel M Fountain, Michael D Jenkinson, Peter Hutchinson, Hani J Marcus, Rory J Piper, Laura Lippa, Franco Servadei, Ignatius Esene, Christian Freyschlag, Iuri Neville, Gail Rosseau, Karl Schaller, Andreas K Demetriades, Faith Robertson, Alex Alamri, Richard Shaw, Andrew G Schache, Stuart C Winter, Michael Ho, Paul Nankivell, Juan Rey Biel, Martin Batstone, Ian Ganly, Raghavan Vidya, Alex Wilkins, Jagdeep K Singh, Dinesh Thekinkattil, Sudha Sundar, Christina Fotopoulou, Elaine Leung, Tabassum Khan, Luis Chiva, Jalid Sehouli, Anna Fagotti, Paul Cohen, Murat Gutelkin, Rahel Ghebre, Thomas Konney, Rene Pareja, Rob Bristow, Sean Dowdy, T S Shylasree, R Kottayasamy Seenivasagam, Joe Ng, Keiiji Fujiwara, Grant D Stewart, Benjamin Lamb, Krishna Narahari, Alan McNeill, Alexandra Colquhoun, John McGrath, Steve Bromage, Ravi Barod, Veeru Kasivisvanathan, Tobias Klatte, Joana Ff Simoes, Tom Ef Abbott, Sadi Abukhalaf, Michel Adamina, Adesoji O Ademuyiwa, Arnav Agarwal, Murat Akkulak, Ehab Alameer, Derek Alderson, Felix Alakaloko, Markus Albertsmeiers, Osaid Alser, Muhammad Alshaar, Sattar Alshryda, Alexis P Arnaud, Knut Magne Augestad, Faris Ayasra, José Azevedo, Brittany K Bankhead-Kendall, Emma Barlow, David Beard, Ruth A Benson, Ruth Blanco-Colino, Amanpreet Brar, Ana Minaya-Bravo, Kerry A Breen, Chris Bretherton, Igor Lima Buarque, Joshua Burke, Edward J Caruana, Mohammad Chaar, Sohini Chakrabortee, Peter Christensen, Daniel Cox, Moises Cukier, Miguel F Cunha, Giana H Davidson, Anant Desai, Salomone Di Saverio, Thomas M Drake, John G Edwards, Muhammed Elhadi, Sameh Emile, Shebani Farik, Marco Fiore, J Edward Fitzgerald, Samuel Ford, Tatiana Garmanova, Gaetano Gallo, Dhruv Ghosh, Gustavo Mendonça Ataíde Gomes, Gustavo Grecinos, Ewen A Griffiths, Madalegna GrÜndl, Constantine Halkias, Ewen M Harrison, Intisar Hisham, Peter J Hutchinson, Shelley Hwang, Arda Isik, Michael D Jenkinson, Pascal Jonker, Haytham Ma Kaafarani, Debby Keller, Angelos Kolias, Schelto Kruijff, Ismail Lawani, Hans Lederhuber, Sezai Leventoglu, Andrey Litvin, Andrew Loehrer, Markus W Löffler, Maria Aguilera Lorena, Maria Marta Modolo, Piotr Major, Janet Martin, Hassan N Mashbari, Dennis Mazingi, Symeon Metallidis, Ana Minaya-Bravo, Helen M Mohan, Rachel Moore, David Moszkowicz, Susan Moug, Joshua S Ng-Kamstra, Mayaba Maimbo, Ionut Negoi, Milagros Niquen, Faustin Ntirenganya, Maricarmen Olivos, Kacimi Oussama, Oumaima Outani, Marie Dione Parreno-Sacdalanm, Francesco Pata, Carlos Jose Perez Rivera, Thomas D Pinkney, Willemijn van der Plas, Peter Pockney, Ahmad Qureshi, Dejan Radenkovic, Antonio Ramos-De la Medina, Keith Roberts, April C Roslani, Martin Rutegård, Juan José Segura-Sampedro, Irène Santos, Sohei Satoi, Raza Sayyed, Andrew Schache, Andreas A Schnitzbauer, Justina O Seyi-Olajide, Neil Sharma, Richard Shaw, Sebastian Shu, Kjetil Soreide, Antonino Spinelli, Grant D Stewart, Malin Sund, Sudha Sundar, Stephen Tabiri, Philip Townend, Georgios Tsoulfas, Gabrielle H van Ramshorst, Raghavan Vidya, Dale Vimalachandran, Oliver J Warren, Duane Wedderburn, Naomi Wright, C Allemand, L Boccalatte, M Figari, M Lamm, J Larrañaga, C Marchitelli, F Noll, D Odetto, M Perrotta, J Saadi, L Zamora, C Alurralde, E L Caram, D Eskinazi, J P Mendoza, M Usandivaras, R Badra, A Esteban, J S García, P M García, J I Gerchunoff, S M Lucchini, M A NIgra, L Vargas, T Hovhannisyan, A Stepanyan, T Gould, R Gourlay, B Griffiths, S Gananadha, M McLaren, J Cecire, N Joshi, S Salindera, A Sutherland, J H Ahn, G Charlton, S Chen, N Gauri, R Hayhurst, S Jang, F Jia, C Mulligan, W Yang, G Ye, H Zhang, M Ballal, D Gibson, D Hayne, J Moss, T Richards, P Viswambaram, U G Vo, J Bennetts, T Bright, M Brooke-Smith, R Fong, B Gricks, Y H Lam, B S Ong, M Szpytma, D Watson, K Bagraith, S Caird, E Chan, C Dawson, D Ho, E Jeyarajan, S Jordan, A Lim, G J Nolan, A Oar, D Parker, H Puhalla, A Quennell, L Rutherford, P Townend, M Von Papen, M Wullschleger, A Blatt, D Cope, N Egoroff, M Fenton, J Gani, N Lott, P Pockney, N Shugg, M Elliott, D Phung, D Phan, D Townend, C Bong, J Gundara, A Frankel, S Bowman, G R Guerra, J Bolt, K Buddingh, N N Dudi-Venkata, S Jog, H M Kroon, T Sammour, R Smith, C Stranz, M Batstone, K Lah, W McGahan, D Mitchell, A Morton, A Pearce, M Roberts, G Sheahan, B Swinson, N Alam, S Banting, L Chong, P Choong, S Clatworthy, D Foley, A Fox, M W Hii, B Knowles, J Mack, M Read, A Rowcroft, S Ward, G Wright, M Lanner, I Königsrainer, M Bauer, C Freyschlag, M Kafka, F Messner, D Öfner, I Tsibulak, K Emmanuel, M Grechenig, R Gruber, M Harald, L Öhlberger, J Presl, A Wimmer, I Namazov, E Samadov, D Barker, R Boyce, S Corbin, A Doyle, A Eastmond, R Gill, A Haynes, S Millar, M O'Shea, G Padmore, N Paquette, E Phillips, S St John, K Walkes, N Flamey, P Pattyn, W Oosterlinck, J Van den Eynde, R Van den Eynde, A Gatti, C Nardi, R Oliva, R De Cicco, I Cecconello, P Gregorio, L Pontual Lima, U Ribeiro Junior, F Takeda, R M Terra, M Sokolov, B Kidane, S Srinathan, M Boutros, N Caminsky, G Ghitulescu, G Jamjoum, J Moon, J Pelletier, T Vanounou, S Wong, M Boutros, S Dumitra, A Kouyoumdjian, B Johnston, C Russell, M Boutros, S Demyttenaere, R Garfinkle, J Abou-Khalil, C Nessim, J Stevenson, F Heredia, A Almeciga, A Fletcher, A Merchan, L O Puentes, J Mendoza Quevedo, G Bacic, D Karlovic, D Krsul, M 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Subjects
Aged, 80 and over, Male, Critical Care, SARS-CoV-2, International Cooperation, COVID-19, Middle Aged, Cohort Studies, Logistic Models, Postoperative Complications, Elective Surgical Procedures, Neoplasms, Outcome Assessment, Health Care, Humans, Female, Epidemics, Aged
Abstract

PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks.

Published
2021

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