Pain perception after colorectal surgery: A propensity score matched prospective cohort study.

The purpose of this prospective cohort study was to compare multimodal pain management and pain perception after open vs. laparoscopic colorectal surgery within enhanced recovery care. Pain scores at rest and at mobilization were prospectively assessed in consecutive patients using Visual Analog Scales (VAS 0-10) and consumption of different analgesics was recorded daily until 96 hours postoperatively. Uni- and multivariate risk factors for pain peaks (≥ 4/10) were identified by logistic regression and compared between two propensity score matched groups (open vs. laparoscopic). 156 open and 176 laparoscopic procedures were included. Mean VAS scores were consistently < 3 until 96 hours at rest and at mobilization. Patients operated by laparoscopy experienced more pain peaks (≥ 4) within 24 hours (p < 0.05), while patients operated by open approach experienced more pain peaks (≥ 4) during mobilization at 72 hours (p < 0.05). Independent risk factors for insufficient pain control (≥ 4) within 24 hours from surgery were duration of the procedure (OR 3.37, 95%CI 2.03-5.59), emergency surgery (OR 3.01, 95%CI 1.72-5.31), wound infiltration (OR 3.23, 95%CI 0.97-10.70), age < 70 years (OR 2.03, 95% CI 1.18-3.48) and ASA I-II score (OR 2.06, 95% CI 1.19-3.56). The perioperative adding of lidocaine ± ketamine to opioids did not improve postoperative pain perception nor decrease morphine equivalents. In conclusion, overall pain scores were low after colorectal surgery. However, pain peaks remained a concern early after minimally invasive surgery and after epidural removal for open surgery. Multimodal strategies were not superior to opioids alone

CARMA Survey Toward Infrared-bright Nearby Galaxies (STING) II: Molecular Gas Star Formation Law and Depletion Time Across the Blue Sequence

We present an analysis of the relationship between molecular gas and current star formation rate surface density at sub-kpc and kpc scales in a sample of 14 nearby star-forming galaxies. Measuring the relationship in the bright, high molecular gas surface density (\Shtwo\gtrsim20 \msunpc) regions of the disks to minimize the contribution from diffuse extended emission, we find an approximately linear relation between molecular gas and star formation rate surface density, \nmol\sim0.96\pm0.16, with a molecular gas depletion time \tdep\sim2.30\pm1.32 Gyr. We show that, in the molecular regions of our galaxies there are no clear correlations between \tdep\ and the free-fall and effective Jeans dynamical times throughout the sample. We do not find strong trends in the power-law index of the spatially resolved molecular gas star formation law or the molecular gas depletion time across the range of galactic stellar masses sampled (\mstar $\sim$$10^{9.7}-10^{11.5}$ \msun). There is a trend, however, in global measurements that is particularly marked for low mass galaxies. We suggest this trend is probably due to the low surface brightness CO, and it is likely associated with changes in CO-to-H2 conversion factor.Comment: To appear in ApJ, December 2011; 17 pages; 8 figure

CARMA Survey Toward Infrared-bright Nearby Galaxies (STING): Molecular Gas Star Formation Law in NGC4254

This study explores the effects of different assumptions and systematics on the determination of the local, spatially resolved star formation law. Using four star formation rate (SFR) tracers (H\alpha with azimuthally averaged extinction correction, mid-infrared 24 micron, combined H\alpha and mid-infrared 24 micron, and combined far-ultraviolet and mid-infrared 24 micron), several fitting procedures, and different sampling strategies we probe the relation between SFR and molecular gas at various spatial resolutions and surface densities within the central 6.5 kpc in the disk of NGC4254. We find that in the high surface brightness regions of NGC4254 the form of the molecular gas star formation law is robustly determined and approximately linear and independent of the assumed fraction of diffuse emission and the SFR tracer employed. When the low surface brightness regions are included, the slope of the star formation law depends primarily on the assumed fraction of diffuse emission. In such case, results range from linear when the fraction of diffuse emission in the SFR tracer is ~30% or less (or when diffuse emission is removed in both the star formation and the molecular gas tracer), to super-linear when the diffuse fraction is ~50% and above. We find that the tightness of the correlation between gas and star formation varies with the choice of star formation tracer. The 24 micron SFR tracer by itself shows the tightest correlation with the molecular gas surface density, whereas the H\alpha corrected for extinction using an azimuthally-averaged correction shows the highest dispersion. We find that for R<0.5R_25 the local star formation efficiency is constant and similar to that observed in other large spirals, with a molecular gas depletion time ~2 Gyr.Comment: accepted for publication in ApJ, vol 729, March 10 2011 issue; 30 pages; 14 figures; revised version includes referee's comments; results unchange

The enerMENA Meteorological Network – Solar Radiation Measurements in the MENA Region

International audienceFor solar resource assessment of solar power plants and adjustment of satellite data, high accuracy measurement data of irradiance and ancillary meteorological data is needed. For the MENA region (Middle East and Northern Africa), which is of high importance for concentrating solar power applications, so far merely 2 publicly available ground measurement stations existed (BSRN network). This gap has been filled by ten stations in Morocco, Algeria, Tunisia, Egypt and Jordan. In this publication the data quality is analyzed by evaluating data completeness and the cleanliness of irradiance sensors in comparison for all of the stations. The pyrheliometers have an average cleanliness of 99.2 % for week-daily cleaning. This is a 5 times higher effort than for Rotating Shadowband Irradiometer (RSI) stations which even have a slightly higher average cleanliness of 99.3 % for weekly cleaning. Furthermore, RSI stations show a data completeness of 99.4 % compared to 93.6 % at the stations equipped with thermal sensors. The results of this analysis are used to derive conclusions concerning instrument choice and are hence also applicable to other solar radiation measurements outside the enerMENA network. It turns out that RSIs are the more reliable and robust choice in cases of high soiling, rare station visits for cleaning and maintenance, as usual in desert sites. Furthermore, annual direct normal and global horizontal irradiation as well as average meteorological parameters are calculated for all of the stations

PHANGS-MUSE: Detection and Bayesian classification of ~40000 ionised nebulae in nearby spiral galaxies

In this work, we present a new catalogue of >40000 ionised nebulae distributed across the 19 galaxies observed by the PHANGS-MUSE survey. The nebulae have been classified using a new model-comparison-based algorithm that exploits the odds ratio principle to assign a probabilistic classification to each nebula in the sample. The resulting catalogue is the largest catalogue containing complete spectral and spatial information for a variety of ionised nebulae available so far in the literature. We developed this new algorithm to address some of the limitations of the traditional classification criteria, such as their binarity, the sharpness of the involved limits, and the limited amount of data they rely on for the classification. The analysis of the catalogue shows that the algorithm performs well when selecting H II regions. We can recover their luminosity function, and its properties are in line with what is available in the literature. We also identify a rather significant population of shock-ionised regions (mostly composed of supernova remnants), an order of magnitude larger than any other homogeneous catalogue of supernova remnants currently available in the literature. The number of supernova remnants we identify per galaxy is in line with results in our Galaxy and other very nearby sources. However, limitations in the source detection algorithm result in an incomplete sample of planetary nebulae, even though their classification seems robust. Finally, we demonstrate how applying a correction for the contribution of the diffuse ionised gas to the nebulae's spectra is essential to obtain a robust classification of the objects and how a correct measurement of the extinction using DIG-corrected line fluxes prompts the use of a higher theoretical Ha/Hb ratio (3.03) than what is commonly used when recovering the E(B-V) via the Balmer decrement technique in massive star-forming galaxies.Comment: 58 pages, 46 figures. Paper accepted for pubblications in A&A. The catalogue will be available via the CDS or at the following link: http://dx.doi.org/10.11570/23.000

Measuring the mixing scale of the ISM within nearby spiral galaxies

The spatial distribution of metals reflects, and can be used to constrain, the processes of chemical enrichment and mixing. Using PHANGS-MUSE optical integral field spectroscopy, we measure the gas phase oxygen abundances (metallicities) across 7,138 HII regions in a sample of eight nearby disc galaxies. In Paper I (Kreckel et al. 2019) we measure and report linear radial gradients in the metallicities of each galaxy, and qualitatively searched for azimuthal abundance variations. Here, we examine the two-dimensional variation in abundances once the radial gradient is subtracted, Delta(O/H), in order to quantify the homogeneity of the metal distribution and to measure the mixing scale over which HII region metallicities are correlated. We observe low (0.03--0.05 dex) scatter in Delta(O/H) globally in all galaxies, with significantly lower (0.02--0.03 dex) scatter on small (<600 pc) spatial scales. This is consistent with the measurement uncertainties, and implies the two-dimensional metallicity distribution is highly correlated on scales of <600 pc. We compute the two point correlation function for metals in the disc in order to quantify the scale lengths associated with the observed homogeneity. This mixing scale is observed to correlate better with the local gas velocity dispersion (of both cold and ionized gas) than with the star formation rate. Selecting only HII regions with enhanced abundances relative to a linear radial gradient, we do not observe increased homogeneity on small scales. This suggests that the observed homogeneity is driven by the mixing introducing material from large scales rather than by pollution from recent and on-going star formation.Comment: 17 pages, 14 figures. Accepted for publication in MNRA

A multi-country study of the “intrapartum stillbirth and early neonatal death indicator” in hospitals in low-resource settings

To determine the feasibility of introducing a simple indicator of quality of obstetric and neonatal care and to determine the proportion of potentially avoidable perinatal deaths in hospitals in low-income countries

Molecular Gas and Star Formation in Nearby Disk Galaxies

We compare molecular gas traced by ^(12)CO (2-1) maps from the HERACLES survey, with tracers of the recent star formation rate (SFR) across 30 nearby disk galaxies. We demonstrate a first-order linear correspondence between Σ_(mol) and Σ_(SFR) but also find important second-order systematic variations in the apparent molecular gas depletion time, τ_(dep)^(mol) = ∑_(mol)/∑_(SFR). At the 1 kpc common resolution of HERACLES, CO emission correlates closely with many tracers of the recent SFR. Weighting each line of sight equally, using a fixed α_(CO) equivalent to the Milky Way value, our data yield a molecular gas depletion time, τ_(dep)^(mol)= ∑_(mol)∑_(SFR) ≈ 2.2 Gyr with 0.3 dex 1σ scatter, in very good agreement with recent literature data. We apply a forward-modeling approach to constrain the power-law index, N, that relates the SFR surface density and the molecular gas surface density, ∑_(SFR) ∝ ∑_(mol)^N. We find N = 1 ± 0.15 for our full data set with some scatter from galaxy to galaxy. This also agrees with recent work, but we caution that a power-law treatment oversimplifies the topic given that we observe correlations between τ_(dep)^(mol) and other local and global quantities. The strongest of these are a decreased τ_(dep)^(mol) in low-mass, low-metallicity galaxies and a correlation of the kpc-scale τ_(dep)^(mol) with dust-to-gas ratio, D/G. These correlations can be explained by a CO-to-H_2 conversion factor (α_(CO)) that depends on dust shielding, and thus D/G, in the theoretically expected way. This is not a unique interpretation, but external evidence of conversion factor variations makes this the most conservative explanation of the strongest observed τ_(dep)^(mol) trends. After applying a D/G-dependent α_(CO), some weak correlations between τ_(dep)^(mol) and local conditions persist. In particular, we observe lower τ_(dep)^(mol) and enhanced CO excitation associated with nuclear gas concentrations in a subset of our targets. These appear to reflect real enhancements in the rate of star formation per unit gas, and although the distribution of τ_(dep) does not appear bimodal in galaxy centers, τ_(dep) does appear multivalued at fixed Σ_(H2), supporting the idea of "disk" and "starburst" modes driven by other environmental parameters

The global abundance of tree palms

Aim Palms are an iconic, diverse and often abundant component of tropical ecosystems that provide many ecosystem services. Being monocots, tree palms are evolutionarily, morphologically and physiologically distinct from other trees, and these differences have important consequences for ecosystem services (e.g., carbon sequestration and storage) and in terms of responses to climate change. We quantified global patterns of tree palm relative abundance to help improve understanding of tropical forests and reduce uncertainty about these ecosystems under climate change. Location Tropical and subtropical moist forests. Time period Current. Major taxa studied Palms (Arecaceae). Methods We assembled a pantropical dataset of 2,548 forest plots (covering 1,191 ha) and quantified tree palm (i.e., ≥10 cm diameter at breast height) abundance relative to co‐occurring non‐palm trees. We compared the relative abundance of tree palms across biogeographical realms and tested for associations with palaeoclimate stability, current climate, edaphic conditions and metrics of forest structure. Results On average, the relative abundance of tree palms was more than five times larger between Neotropical locations and other biogeographical realms. Tree palms were absent in most locations outside the Neotropics but present in >80% of Neotropical locations. The relative abundance of tree palms was more strongly associated with local conditions (e.g., higher mean annual precipitation, lower soil fertility, shallower water table and lower plot mean wood density) than metrics of long‐term climate stability. Life‐form diversity also influenced the patterns; palm assemblages outside the Neotropics comprise many non‐tree (e.g., climbing) palms. Finally, we show that tree palms can influence estimates of above‐ground biomass, but the magnitude and direction of the effect require additional work. Conclusions Tree palms are not only quintessentially tropical, but they are also overwhelmingly Neotropical. Future work to understand the contributions of tree palms to biomass estimates and carbon cycling will be particularly crucial in Neotropical forests