Optical spectroscopic variability of Herbig Ae/Be stars

We analysed 337 multi-epoch optical spectra of 38 Herbig Ae/Be (HAeBe) stars to gain insights into the variability behaviour of the circumstellar (CS) atomic gas. Equivalent widths (EWs) and line fluxes of the Halpha, [OI]6300, HeI5876 and NaID lines were obtained for each spectrum; the Halpha line width at 10% of peak intensity (W10) and profile shapes were also measured and classified. The mean line strengths and relative variabilities were quantified for each star. Simultaneous optical photometry was used to estimate the line fluxes. We present a homogeneous spectroscopic database of HAeBe stars. The lines are variable in practically all stars and timescales, although 30 % of the objects show a constant EW in [OI]6300, which is also the only line that shows no variability on timescales of hours. The HeI5876 and NaID EW relative variabilities are typically the largest, followed by those in [OI]6300 and Halpha. The EW changes can be larger than one order of magnitude for the HeI5876 line, and up to a factor 4 for Halpha. The [OI]6300 and Halpha EW relative variabilities are correlated for most stars in the sample. The Halpha mean EW and W10 are uncorrelated, as are their relative variabilities. The Halpha profile changes in 70 % of the objects. The massive stars in the sample usually show more stable Halpha profiles with blueshifted self-absorptions and less variable 10% widths. Our data suggest multiple causes for the different line variations, but the [OI]6300 and Halpha variability must share a similar origin in many objects. The physical mechanism responsible for the Halpha line broadening does not depend on the amount of emission; unlike in lower-mass stars, physical properties based on the Halpha luminosity and W10 would significantly differ. Our results provide additional support to previous works that reported different physical mechanisms in Herbig Ae and Herbig Be stars.Comment: 10 pages, 5 figures, 2 appendixe

Accretion-related properties of Herbig Ae/Be stars. Comparison with T Tauris

We look for trends relating the mass accretion rate (Macc) and the stellar ages (t), spectral energy distributions (SEDs), and disk masses (Mdisk) for a sample of 38 HAeBe stars, comparing them to analogous correlations found for classical T Tauri stars. Our goal is to shed light on the timescale and physical processes that drive evolution of intermediate-mass pre-main sequence objects. Macc shows a dissipation timescale \tau = 1.3^{+1.0}_{-0.5} Myr from an exponential law fit, while a power law yields Macc(t) \propto t^{-\eta}, with \eta = 1.8^{+1.4}_{-0.7}. This result is based on our whole HAeBe sample (1-6 Msun), but the accretion rate decline most probably depends on smaller stellar mass bins. The near-IR excess is higher and starts at shorter wavelengths (J and H bands) for the strongest accretors. Active and passive disks are roughly divided by 2 x 10^{-7} Msun/yr. The mid-IR excess and the SED shape from the Meeus et al. classification are not correlated with Macc. We find Macc \propto Mdisk^{1.1 +- 0.3}. Most stars in our sample with signs of inner dust dissipation typically show accretion rates ten times lower and disk masses three times smaller than the remaining objects. The trends relating Macc with the near-IR excess and Mdisk extend those for T Tauri stars, and are consistent with viscous disk models. The differences in the inner gas dissipation timescale, and the relative position of the stars with signs of inner dust clearing in the Macc-Mdisk plane, could be suggesting a slightly faster evolution, and that a different process - such as photoevaporation - plays a more relevant role in dissipating disks in the HAeBe regime compared to T Tauri stars. Our conclusions must consider the mismatch between the disk mass estimates from mm fluxes and the disk mass estimates from accretion, which we also find in HAeBe stars.Comment: 11 pages, 7 figures, 1 appendix. Accepted in A&

GASPS observations of Herbig Ae/Be stars with PACS/Herschel. The atomic and molecular content of their protoplanetary discs

We observed a sample of 20 representative Herbig Ae/Be stars and five A-type debris discs with PACS onboard of Herschel. The observations were done in spectroscopic mode, and cover far-IR lines of [OI], [CII], CO, CH+, H2O and OH. We have a [OI]63 micron detection rate of 100% for the Herbig Ae/Be and 0% for the debris discs. [OI]145 micron is only detected in 25%, CO J=18-17 in 45% (and less for higher J transitions) of the Herbig Ae/Be stars and for [CII] 157 micron, we often found spatially variable background contamination. We show the first detection of water in a Herbig Ae disc, HD 163296, which has a settled disc. Hydroxyl is detected as well in this disc. CH+, first seen in HD 100546, is now detected for the second time in a Herbig Ae star, HD 97048. We report fluxes for each line and use the observations as line diagnostics of the gas properties. Furthermore, we look for correlations between the strength of the emission lines and stellar or disc parameters, such as stellar luminosity, UV and X-ray flux, accretion rate, PAH band strength, and flaring. We find that the stellar UV flux is the dominant excitation mechanism of [OI]63 micron, with the highest line fluxes found in those objects with a large amount of flaring and greatest PAH strength. Neither the amount of accretion nor the X-ray luminosity has an influence on the line strength. We find correlations between the line flux of [OI]63 micron and [OI]145 micron, CO J = 18-17 and [OI]6300 \AA, and between the continuum flux at 63 micron and at 1.3 mm, while we find weak correlations between the line flux of [OI]63 micron and the PAH luminosity, the line flux of CO J = 3-2, the continuum flux at 63 micron, the stellar effective temperature and the Brgamma luminosity. (Abbreviated version)Comment: 20 pages, 29 figures, accepted by Astronomy and Astrophysic

Height and timing of growth spurt during puberty in young people living with vertically acquired HIV in Europe and Thailand.

OBJECTIVE: The aim of this study was to describe growth during puberty in young people with vertically acquired HIV. DESIGN: Pooled data from 12 paediatric HIV cohorts in Europe and Thailand. METHODS: One thousand and ninety-four children initiating a nonnucleoside reverse transcriptase inhibitor or boosted protease inhibitor based regimen aged 1-10 years were included. Super Imposition by Translation And Rotation (SITAR) models described growth from age 8 years using three parameters (average height, timing and shape of the growth spurt), dependent on age and height-for-age z-score (HAZ) (WHO references) at antiretroviral therapy (ART) initiation. Multivariate regression explored characteristics associated with these three parameters. RESULTS: At ART initiation, median age and HAZ was 6.4 [interquartile range (IQR): 2.8, 9.0] years and -1.2 (IQR: -2.3 to -0.2), respectively. Median follow-up was 9.1 (IQR: 6.9, 11.4) years. In girls, older age and lower HAZ at ART initiation were independently associated with a growth spurt which occurred 0.41 (95% confidence interval 0.20-0.62) years later in children starting ART age 6 to 10 years compared with 1 to 2 years and 1.50 (1.21-1.78) years later in those starting with HAZ less than -3 compared with HAZ at least -1. Later growth spurts in girls resulted in continued height growth into later adolescence. In boys starting ART with HAZ less than -1, growth spurts were later in children starting ART in the oldest age group, but for HAZ at least -1, there was no association with age. Girls and boys who initiated ART with HAZ at least -1 maintained a similar height to the WHO reference mean. CONCLUSION: Stunting at ART initiation was associated with later growth spurts in girls. Children with HAZ at least -1 at ART initiation grew in height at the level expected in HIV negative children of a comparable age

Prognostic factors of a lower CD4/CD8 ratio in long term viral suppression HIV infected children

Background Combination antiretroviral therapy (cART) is associated with marked immune reconstitution. Although a long term viral suppression is achievable, not all children however, attain complete immunological recovery due to persistent immune activation. We use CD4/CD8 ratio like a marker of immune reconstitution. Methods Perinatal HIV-infected children who underwent a first-line cART, achieved viral suppression in the first year and maintained it for more than 5 years, with no viral rebound were included. Logistic models were applied to estimate the prognostic factors, clinical characteristics at cART start, of a lower CD4/CD8 ratio at the last visit. Results 146 HIV-infected children were included: 77% Caucasian, 45% male and 28% CDC C. Median age at cART initiation was 2.3 years (IQR: 0.5-6.2). 42 (30%) children received mono-dual therapy previously to cART. Time of undetectable viral load was 9.5 years (IQR: 7.8, 12.5). 33% of the children not achieved CD4/CD8 ratio >1. Univariate analysis showed an association between CD4/CD8 <1 with lower CD4 nadir and baseline CD4; older age at diagnosis and at cART initiation; and a previous exposure to mono-dual therapy. Multivariate analysis also revealed relationship between CD4/CD8 <1 and lower CD4 nadir (OR: 1.002, CI 95% 1.000-1.004) as well as previous exposure to mono-dual therapy (OR: 0.16, CI 95% 0.003-0.720). Conclusions CD4/CD8 > 1 was not achieved in 33% of the children. Lower CD4 nadir and previous exposure to suboptimal therapy, before initiating cART, are factors showing independently association with a worse immune recovery (CD4/CD8 < 1)

Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study

PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

Meeting abstrac