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.

Web search engines have become the dominant tools for finding information on the Internet. Due to their popularity, users apply them to a wide range of search needs, from simple look-ups to rather complex information tasks. This paper presents the results of a study that investigated the characteristics of these complex information needs in the context of Web search engines. The aim of the study was to find out more about (1) what makes complex search tasks distinct from simple tasks and whether it is possible to find simple measures for describing their complexity, (2) whether search success for a task can be predicted by means of unique measures, and (3) whether successful searchers show a different behaviour than unsuccessful searchers. The study includes 56 ordinary Web users who carried out a set of 12 search tasks using current commercial search engines. Their behaviour was logged with the Search-Logger tool. The results confirm that complex tasks show significantly different characteristics than simple tasks. Successful search behaviour can be distinguished from unsuccessful search behaviour. The implications of these findings for search engine vendors are discussed.

Search engines such as Google, Bing, and Yahoo, supplemented by other information search portals like Wikipedia, have become the means for searching information on the Internet. Along with the increasing popularity of search engines, the academic interest in search has shifted from analysing simple look-up query and response patterns to analysing rather complex information seeking needs. Current search tools seem to support complex search not as well as they do in the case of look-up. Especially support for aggregating search results from multiple search-queries, taking into account discoveries made during a complex search task, and synthesizing them to some newly compiled document of information is only at the beginning and motivates researchers to develop new tools for supporting those information seeking techniques. We focus in this work on the exploratory search concepts aggregation, discovery, and synthesis. Our idea is that these are today the most time consuming activities, especially when fulfilling a complex information need. We will use these three concepts throughout this paper to evaluate different approaches in exploratory search and give an overview of the state of the art and current ongoing research in respect to these concepts.

Search engines are the preferred tools for finding information on the Web. They are advancing to be the common helpers to answer any of our search needs. We use them to carry out simple look-up tasks and also to work on rather time consuming and more complex search tasks. Yet, we do not know very much about the user performance while carrying out those tasks -especially not for ordinary users. The aim of this study was to get more insight into whether Web users manage to assess difficulty, time effort, query effort, and task outcome of search tasks, and if their judging performance relates to task complexity. Our study was conducted with a systematically selected sample of 56 people with a wide demographic background. They carried out a set of 12 search tasks with commercial Web search engines in a laboratory environment. The results confirm that it is hard for normal Web users to judge the difficulty and effort to carry out complex search tasks. The judgments are more reliable for simple tasks than for complex ones. Task complexity is an indicator for judging performance.