First MATISSE L-band observations of HD 179218: is the inner 10 au region rich in carbon dust particles?

Stars and planetary system

An international assessment of the adoption of enhanced recovery after surgery (ERAS®) principles across colorectal units in 2019–2020

Aim: The Enhanced Recovery After Surgery (ERAS®) Society guidelines aim to standardize perioperative care in colorectal surgery via 25 principles. We aimed to assess the variation in uptake of these principles across an international network of colorectal units. Method: An online survey was circulated amongst European Society of Coloproctology members in 2019–2020. For each ERAS principle, respondents were asked to score how frequently the principle was implemented in their hospital, from 1 (‘rarely’) to 4 (‘always’). Respondents were also asked to recall whether practice had changed since 2017. Subgroup analyses based on hospital characteristics were conducted. Results: Of hospitals approached, 58% responded to the survey (195/335), with 296 individual responses (multiple responses were received from some hospitals). The majority were European (163/195, 83.6%). Overall, respondents indicated they ‘most often’ or ‘always’ adhered to most individual ERAS principles (18/25, 72%). Variability in the uptake of principles was reported, with universal uptake of some principles (e.g., prophylactic antibiotics; early mobilization) and inconsistency from ‘rarely’ to ‘always’ in others (e.g., no nasogastric intubation; no preoperative fasting and carbohydrate drinks). In alignment with 2018 ERAS guideline updates, adherence to principles for prehabilitation, managing anaemia and postoperative nutrition appears to have increased since 2017. Conclusions: Uptake of ERAS principles varied across hospitals, and not all 25 principles were equally adhered to. Whilst some principles exhibited a high level of acceptance, others had a wide variability in uptake indicative of controversy or barriers to uptake. Further research into specific principles is required to improve ERAS implementation

First MATISSE L-band observations of HD 179218: Is the inner 10 au region rich in carbon dust particles?

Context. Carbon is one of the most abundant components in the Universe. While silicates have been the main focus of solid phase studies in protoplanetary discs (PPDs), little is known about the solid carbon content especially in the planet-forming regions (~0.1-10 au). Fortunately, several refractory carbonaceous species present C-H bonds (such as hydrogenated nano-diamond and amorphous carbon as well as polycyclic aromatic hydrocarbons), which generate infrared (IR) features that can be used to trace the solid carbon reservoirs. The new mid-IR instrument MATISSE, installed at the Very Large Telescope Interferometer (VLTI), can spatially resolve the inner regions (~1-10 au) of PPDs and locate, down to the au-scale, the emission coming from carbon grains. Aims: Our aim is to provide a consistent view on the radial structure, down to the au-scale, as well as basic physical properties and the nature of the material responsible for the IR continuum emission in the inner disk region around HD 179218. Methods: We implemented a temperature-gradient model to interpret the disk IR continuum emission, based on a multiwavelength dataset comprising a broadband spectral energy distribution and VLTI H-, L-, and N-bands interferometric data obtained in low spectral resolution. Then, we added a ring-like component, representing the carbonaceous L-band features-emitting region, to assess its detectability in future higher spectral resolution observations employing mid-IR interferometry. Results: Our temperature-gradient model can consistently reproduce our dataset. We confirmed a spatially extended inner 10 au emission in H- and L-bands, with a homogeneously high temperature (~1700 K), which we associate with the presence of stochastically heated nano-grains. On the other hand, the N-band emitting region presents a ring-like geometry that starts at about 10 au with a temperature of 400 K. Moreover, the existing low resolution MATISSE data exclude the presence of aromatic carbon grains (i.e., producing the 3.3 μm feature) in close proximity tothe star (≲1 au). Future medium spectral resolution MATISSE data will confirm their presence at larger distances. Conclusions: Our best-fit model demonstrates the presence of two separated dust populations: nano-grains that dominate the near- to mid-IR emission in the inner 10 au region and larger grains that dominate the emission outward. The presence of such nano-grains in the highly irradiated inner 10 au region of HD 179218 requires a replenishment process. Considering the expected lifetime of carbon nano-grains from The Heterogeneous dust Evolution Model for Interstellar Solids (THEMIS model), the estimated disk accretion inflow of HD 179218 could significantly contribute to feed the inner 10 au region in nano-grains.Moreover, we also expect a local regeneration of those nano-grains by the photo-fragmentation of larger aggregates

First MATISSE L-band observations of HD 179218: Is the inner 10 au region rich in carbon dust particles?

Context. Carbon is one of the most abundant components in the Universe. While silicates have been the main focus of solid phase studies in protoplanetary discs (PPDs), little is known about the solid carbon content especially in the planet-forming regions (~0.1-10 au). Fortunately, several refractory carbonaceous species present C-H bonds (such as hydrogenated nano-diamond and amorphous carbon as well as polycyclic aromatic hydrocarbons), which generate infrared (IR) features that can be used to trace the solid carbon reservoirs. The new mid-IR instrument MATISSE, installed at the Very Large Telescope Interferometer (VLTI), can spatially resolve the inner regions (~1-10 au) of PPDs and locate, down to the au-scale, the emission coming from carbon grains. Aims: Our aim is to provide a consistent view on the radial structure, down to the au-scale, as well as basic physical properties and the nature of the material responsible for the IR continuum emission in the inner disk region around HD 179218. Methods: We implemented a temperature-gradient model to interpret the disk IR continuum emission, based on a multiwavelength dataset comprising a broadband spectral energy distribution and VLTI H-, L-, and N-bands interferometric data obtained in low spectral resolution. Then, we added a ring-like component, representing the carbonaceous L-band features-emitting region, to assess its detectability in future higher spectral resolution observations employing mid-IR interferometry. Results: Our temperature-gradient model can consistently reproduce our dataset. We confirmed a spatially extended inner 10 au emission in H- and L-bands, with a homogeneously high temperature (~1700 K), which we associate with the presence of stochastically heated nano-grains. On the other hand, the N-band emitting region presents a ring-like geometry that starts at about 10 au with a temperature of 400 K. Moreover, the existing low resolution MATISSE data exclude the presence of aromatic carbon grains (i.e., producing the 3.3 μm feature) in close proximity tothe star (≲1 au). Future medium spectral resolution MATISSE data will confirm their presence at larger distances. Conclusions: Our best-fit model demonstrates the presence of two separated dust populations: nano-grains that dominate the near- to mid-IR emission in the inner 10 au region and larger grains that dominate the emission outward. The presence of such nano-grains in the highly irradiated inner 10 au region of HD 179218 requires a replenishment process. Considering the expected lifetime of carbon nano-grains from The Heterogeneous dust Evolution Model for Interstellar Solids (THEMIS model), the estimated disk accretion inflow of HD 179218 could significantly contribute to feed the inner 10 au region in nano-grains.Moreover, we also expect a local regeneration of those nano-grains by the photo-fragmentation of larger aggregates

An international assessment of the adoption of enhanced recovery after surgery (ERAS®) principles across colorectal units in 2019–2020

AimThe Enhanced Recovery After Surgery (ERAS®) Society guidelines aim to standardize perioperative care in colorectal surgery via 25 principles. We aimed to assess the variation in uptake of these principles across an international network of colorectal units.MethodAn online survey was circulated amongst European Society of Coloproctology members in 2019–2020. For each ERAS principle, respondents were asked to score how frequently the principle was implemented in their hospital, from 1 (‘rarely’) to 4 (‘always’). Respondents were also asked to recall whether practice had changed since 2017. Subgroup analyses based on hospital characteristics were conducted.ResultsOf hospitals approached, 58% responded to the survey (195/335), with 296 individual responses (multiple responses were received from some hospitals). The majority were European (163/195, 83.6%). Overall, respondents indicated they ‘most often’ or ‘always’ adhered to most individual ERAS principles (18/25, 72%). Variability in the uptake of principles was reported, with universal uptake of some principles (e.g., prophylactic antibiotics; early mobilization) and inconsistency from ‘rarely’ to ‘always’ in others (e.g., no nasogastric intubation; no preoperative fasting and carbohydrate drinks). In alignment with 2018 ERAS guideline updates, adherence to principles for prehabilitation, managing anaemia and postoperative nutrition appears to have increased since 2017.ConclusionsUptake of ERAS principles varied across hospitals, and not all 25 principles were equally adhered to. Whilst some principles exhibited a high level of acceptance, others had a wide variability in uptake indicative of controversy or barriers to uptake. Further research into specific principles is required to improve ERAS implementation.AimThe Enhanced Recovery After Surgery (ERAS®) Society guidelines aim to standardize perioperative care in colorectal surgery via 25 principles. We aimed to assess the variation in uptake of these principles across an international network of colorectal units.MethodAn online survey was circulated amongst European Society of Coloproctology members in 2019–2020. For each ERAS principle, respondents were asked to score how frequently the principle was implemented in their hospital, from 1 (‘rarely’) to 4 (‘always’). Respondents were also asked to recall whether practice had changed since 2017. Subgroup analyses based on hospital characteristics were conducted.ResultsOf hospitals approached, 58% responded to the survey (195/335), with 296 individual responses (multiple responses were received from some hospitals). The majority were European (163/195, 83.6%). Overall, respondents indicated they ‘most often’ or ‘always’ adhered to most individual ERAS principles (18/25, 72%). Variability in the uptake of principles was reported, with universal uptake of some principles (e.g., prophylactic antibiotics; early mobilization) and inconsistency from ‘rarely’ to ‘always’ in others (e.g., no nasogastric intubation; no preoperative fasting and carbohydrate drinks). In alignment with 2018 ERAS guideline updates, adherence to principles for prehabilitation, managing anaemia and postoperative nutrition appears to have increased since 2017.ConclusionsUptake of ERAS principles varied across hospitals, and not all 25 principles were equally adhered to. Whilst some principles exhibited a high level of acceptance, others had a wide variability in uptake indicative of controversy or barriers to uptake. Further research into specific principles is required to improve ERAS implementation.A

Safety of primary anastomosis following emergency left sided colorectal resection: an international, multi-centre prospective audit.

This is the peer reviewed version of the following article: group, T. E. S. o. C. c. (2018). "Safety of primary anastomosis following emergency left sided colorectal resection: an international, multi-centre prospective audit." Colorectal Disease 20(S6): 47-57., which has been published in final form at https://doi.org/10.1111/codi.1437. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived VersionsINTRODUCTION: Some evidence suggests that primary anastomosis following left sided colorectal resection in the emergency setting may be safe in selected patients, and confer favourable outcomes to permanent enterostomy. The aim of this study was to compare the major postoperative complication rate in patients undergoing end stoma vs primary anastomosis following emergency left sided colorectal resection. METHODS: A pre-planned analysis of the European Society of Coloproctology 2017 audit. Adult patients (> 16 years) who underwent emergency (unplanned, within 24 h of hospital admission) left sided colonic or rectal resection were included. The primary endpoint was the 30-day major complication rate (Clavien-Dindo grade 3 to 5). RESULTS: From 591 patients, 455 (77%) received an end stoma, 103 a primary anastomosis (17%) and 33 primary anastomosis with defunctioning stoma (6%). In multivariable models, anastomosis was associated with a similar major complication rate to end stoma (adjusted odds ratio for end stoma 1.52, 95%CI 0.83-2.79, P = 0.173). Although a defunctioning stoma was not associated with reduced anastomotic leak (12% defunctioned [4/33] vs 13% not defunctioned [13/97], adjusted odds ratio 2.19, 95%CI 0.43-11.02, P = 0.343), it was associated with less severe complications (75% [3/4] with defunctioning stoma, 86.7% anastomosis only [13/15]), a lower mortality rate (0% [0/4] vs 20% [3/15]), and fewer reoperations (50% [2/4] vs 73% [11/15]) when a leak did occur. CONCLUSIONS: Primary anastomosis in selected patients appears safe after left sided emergency colorectal resection. A defunctioning stoma might mitigate against risk of subsequent complications

An international assessment of the adoption of enhanced recovery after surgery (ERAS®) principles across colorectal units in 2019–2020

Aim: The Enhanced Recovery After Surgery (ERAS®) Society guidelines aim to standardize perioperative care in colorectal surgery via 25 principles. We aimed to assess the variation in uptake of these principles across an international network of colorectal units. Method: An online survey was circulated amongst European Society of Coloproctology members in 2019–2020. For each ERAS principle, respondents were asked to score how frequently the principle was implemented in their hospital, from 1 (‘rarely’) to 4 (‘always’). Respondents were also asked to recall whether practice had changed since 2017. Subgroup analyses based on hospital characteristics were conducted. Results: Of hospitals approached, 58% responded to the survey (195/335), with 296 individual responses (multiple responses were received from some hospitals). The majority were European (163/195, 83.6%). Overall, respondents indicated they ‘most often’ or ‘always’ adhered to most individual ERAS principles (18/25, 72%). Variability in the uptake of principles was reported, with universal uptake of some principles (e.g., prophylactic antibiotics; early mobilization) and inconsistency from ‘rarely’ to ‘always’ in others (e.g., no nasogastric intubation; no preoperative fasting and carbohydrate drinks). In alignment with 2018 ERAS guideline updates, adherence to principles for prehabilitation, managing anaemia and postoperative nutrition appears to have increased since 2017. Conclusions: Uptake of ERAS principles varied across hospitals, and not all 25 principles were equally adhered to. Whilst some principles exhibited a high level of acceptance, others had a wide variability in uptake indicative of controversy or barriers to uptake. Further research into specific principles is required to improve ERAS implementation