The Early Evolution of Stars and Exoplanet Systems: Exploring and Exploiting Nearby, Young Stars

Our knowledge of the population of young (age ≾750 Myr) stars that lie within ~120 pc of the Sun is rapidly accelerating. The vast majority of these nearby, young stars can be placed in kinematically coherent groups (nearby, young moving groups; NYMGs). NYMGs and their member stars afford unmatched opportunities to explore a wide variety of aspects of the early evolution of stars and exoplanet systems, including stellar initial mass functions and age determination methods; the magnetic activities and high-energy radiation environments of young, late-type stars; the dynamics of young binary and hierarchical multiple systems; the late evolutionary stages of circumstellar disks; and, especially, direct-imaging discovery and characterization of massive young exoplanets. In this Astro2020 Science White Paper, we describe how our understanding of these and many other aspects of the early lives of stars and planetary systems is ripe for progress over the next decade via the identification and study of NYMG members with present and next-generation facilities and instruments

The Early Evolution of Stars and Exoplanet Systems: Exploring and Exploiting Nearby, Young Stars

Our knowledge of the population of young (age ≾750 Myr) stars that lie within ~120 pc of the Sun is rapidly accelerating. The vast majority of these nearby, young stars can be placed in kinematically coherent groups (nearby, young moving groups; NYMGs). NYMGs and their member stars afford unmatched opportunities to explore a wide variety of aspects of the early evolution of stars and exoplanet systems, including stellar initial mass functions and age determination methods; the magnetic activities and high-energy radiation environments of young, late-type stars; the dynamics of young binary and hierarchical multiple systems; the late evolutionary stages of circumstellar disks; and, especially, direct-imaging discovery and characterization of massive young exoplanets. In this Astro2020 Science White Paper, we describe how our understanding of these and many other aspects of the early lives of stars and planetary systems is ripe for progress over the next decade via the identification and study of NYMG members with present and next-generation facilities and instruments

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely