Blog – Page 7560

The news: IBM has built a new chemistry lab called RoboRXN in the cloud. It combines AI models, a cloud computing platform, and robots to help scientists design and synthesize new molecules while working from home.

How it works: The online lab platform allows scientists to log on through a web browser. On a blank canvas, they draw the skeletal structure of the molecular compounds they want to make, and the platform uses machine learning to predict the ingredients required and the order in which they should be mixed. It then sends the instructions to a robot in a remote lab to execute. Once the experiment is done, the platform sends a report to the scientists with the results.

Why it matters: New drugs and materials traditionally require an average of 10 years and $10 million to discover and bring to market. Much of that time is taken up by the laborious repetition of experiments to synthesize new compounds and learn from trial and error. IBM hopes that a platform like RoboRXN could dramatically speed up that process by predicting the recipes for compounds and automating experiments. In theory, it would lower the costs of drug development and allow scientists to react faster to health crises like the current pandemic, in which social distancing requirements have caused slowdowns in lab work.

The coronavirus disease 2019 (COVID-19) pandemic has had a global impact on all aspects of health care, including surgical procedures. For urologists, it has affected and will continue to influence how we approach the care of patients preoperatively, intraoperatively, and postoperatively. A risk-benefit assessment of each patient undergoing surgery should be performed during the COVID-19 pandemic based on the urgency of the surgery and the risk of viral illness and transmission. Patients with advanced age and comorbidities have a higher incidence of mortality. Routine preoperative testing and symptom screening is recommended to identify those with COVID-19. Adequate personal protective equipment (PPE) for the surgical team is essential to protect health care workers and ensure an adequate workforce. For COVID-19 positive or suspected patients, the use of N95 respirators is recommended if available. The anesthesia method chosen should attempt to minimize aerosolization of the virus. Negative pressure rooms are strongly preferred for intubation/extubation and other aerosolizing procedures for COVID-19 positive patients or when COVID status is unknown. Although transmission has not yet been shown during laparoscopic and robotic procedures, efforts should be made to minimize the risk of aerosolization. Ultra-low particulate air filters are recommended for use during minimally invasive procedures to decrease the risk of viral transmission. Thorough cleaning and sterilization should be performed postoperatively with adequate time allowed for the operating room air to be cycled after procedures. COVID-19 patients should be separated from noninfected patients at all levels of care, including recovery, to decrease the risk of infection. Future directions will be guided by outcomes and infection rates as social distancing guidelines are relaxed and more surgical procedures are reintroduced. Recommendations should be adapted to the local environment and will continue to evolve as more data become available, the shortage of testing and PPE is resolved, and a vaccine and therapeutics for COVID-19 are developed.

The first reported cases of coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), originated in Wuhan City, Hubei Province, China in December 2019. This respiratory disease spread outside of China, leading to outbreaks in Korea, Iran, Italy, and, eventually, the United States and the rest of the world. On March 11, 2020, the World Health Organization (WHO) declared the outbreak to be a pandemic. At the time of this writing, there are currently more than 1.3 million confirmed cases worldwide, with the total deaths numbering more than 74,000.¹ This pandemic is unlike anything that has been seen in recent history.

From a urologic surgery perspective, many questions arise regarding the immediate and long-term care of our patients. The goal of this article is to summarize some of the current information available on preoperative, intraoperative, and postoperative care. As we gain more knowledge about how the virus behaves, this body of literature will inevitably change.