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BACKGROUND: Determining the infection rate and mortality probability in healthy patients who have undergone orthopedic and trauma surgeries (OTS) during a period of uncontrolled COVID-19 transmission may help to inform preparations for future waves. This study performed a survival analysis in a cohort of non-infected OTS patients and determined the effect of COVID-19 on mortality. METHODS: This observational study included 184 patients who underwent OTS in the month before surgical activities ceased and before the implementation of special measures. Four groups of surgery (GS) were established based on the location of the surgery and the grade of inflammation produced. Crude risk of infection and infection rates were assessed. Survival and failure functions by GS were analyzed. Comparison of the Kaplan-Meier survival curves by GS was assessed. Cox regression and Fine-Gray models were used to determine the effect of different confounders on mortality. RESULTS: The crude risk of COVID-19 diagnosis was 14.13% (95% CI: 9.83-19.90%). The total incidence rate was 2.67 (1000 person-days, 95% CI: 1.74-3.91). At the end of follow-up, there was a 94.42% chance of surviving 76 days or more after OTS. The differences in K-M survivor curves by GS indicated that GS 4 presented a lower survival function (Mantel-Cox test, p = 0.024; Wilcoxon-Breslow test, p = 0.044; Tarone-Ware test, p = 0.032). One of the best models to determine the association with mortality was the age-adjusted model for GS, high blood pressure, and respiratory history, with a hazard ratio of 1.112 in Cox regression analysis (95% CI: 1.005-1.230) and a sub hazard ratio of 1.111 (95% CI: 1.046-1.177) in Fine-Gray regression analysis for competitive risk. CONCLUSIONS: The infection risk after OTS was similar to that of the general population in a community transmission area; the grade of surgical aggression did not influence this rate. The survival probability was extremely high if patients had not previously been infected. With higher grades of surgical aggression, the risk of mortality was higher in OTS patients. Adjusting for age and other confounders (e.g., GS, high blood pressure and respiratory history) was associated with higher mortality rates.
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COVID-19 , Agresión , Prueba de COVID-19 , Humanos , SARS-CoV-2 , Análisis de SupervivenciaRESUMEN
The design, fabrication, and characterization of an 8×8 lossless optical switch, based on semiconductor optical amplifier (SOA) gates, is reported. It comprises three stages of 2×2 switches into an 8×8 Banyan switch, for a total of 48 SOAs. Three SOAs on each optical path provide gain to compensate for on-chip and fiber coupling loss, thereby making the optical switch lossless. All 64 optical paths demonstrate error-free 10 Gbps NRZ PRBS-31 transmission with at least 30 dB signal-to-noise ratio and less than 0.9 dB power penalty.
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We report the interferometric photodetection of a phase-diffusion quantum entropy source in a silicon photonics chip. The device uses efficient and robust single-laser accelerated phase diffusion methods, and implements the unbalanced Mach-Zehnder interferometer with optimized splitting ratio and photodetection, in a 0.5 mm×1 mm footprint. We demonstrate Gbps raw entropy-generation rates in a technology compatible with conventional CMOS fabrication techniques.
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With the rapid development of the modern communication systems, radar and wireless services, microwave signal with high-frequency, high-spectral-purity and frequency tunability as well as microwave generator with light weight, compact size, power-efficient and low cost are increasingly demanded. Integrated microwave photonics (IMWP) is regarded as a prospective way to meet these demands by hybridizing the microwave circuits and the photonics circuits on chip. In this article, we propose and experimentally demonstrate an integrated optoelectronic oscillator (IOEO). All of the devices needed in the optoelectronic oscillation loop circuit are monolithically integrated on chip within size of 5×6cm2. By tuning the injection current to 44 mA, the output frequency of the proposed IOEO is located at 7.30 GHz with phase noise value of -91 dBc/Hz@1MHz. When the injection current is increased to 65 mA, the output frequency can be changed to 8.87 GHz with phase noise value of -92 dBc/Hz@1MHz. Both of the oscillation frequency can be slightly tuned within 20 MHz around the center oscillation frequency by tuning the injection current. The method about improving the performance of IOEO is carefully discussed at the end of in this article.
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We propose the use of silicon graphene waveguides to implement a tunable broadband microwave photonics phase shifter based on integrated ring cavities. Numerical computation results show the feasibility for broadband operation over 40 GHz bandwidth and full 360° radiofrequency phase-shift with a modest voltage excursion of 0.12 volt.
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We propose the use of interleaved graphene sections on top of a silicon waveguide to implement tunable Bragg gratings. The filter central wavelength and bandwidth can be controlled changing the chemical potential of the graphene sections. Apodization techniques are also presented.