A Library of Integrated Spectra of Galactic Globular Clusters

We present a new library of integrated spectra of 40 Galactic globular clusters, obtained with the Blanco 4-m telescope and the R-C spectrograph at the Cerro Tololo Interamerican Observatory. The spectra cover the range ~ 3350 -- 6430 A with ~ 3.1 A (FWHM) resolution. The spectroscopic observations and data reduction were designed to integrate the full projected area within the cluster core radii in order to properly sample the light from stars in all relevant evolutionary stages. The S/N values of the flux-calibrated spectra range from 50 to 240/A at 4000 A and from 125 to 500/A at 5000 A. The selected targets span a wide range of cluster parameters, including metallicity, horizontal-branch morphology, Galactic coordinates, Galactocentric distance, and concentration. The total sample is thus fairly representative of the entire Galactic globular cluster population and should be valuable for comparison with similar integrated spectra of unresolved stellar populations in remote systems. For most of the library clusters, our spectra can be coupled with deep color-magnitude diagrams and reliable metal abundances from the literature to enable the calibration of stellar population synthesis models. In this paper we present a detailed account of the observations and data reduction. The spectral library is publicly available in electronic format from the National Optical Astronomical Observatory website.Comment: 39 Pages, including 2 tables and 15 Figures. To appear in the Astrophysical Journal, Supplement Serie

The Lower Main Sequence and Mass Function of the Globular Cluster Messier 4

The deepest optical image ever in a globular star cluster, a Hubble Space Telescope (HST) 123 orbit exposure in a single field of Messier 4, was obtained in 2 filters (F606W, F814W) over a 10 week period in early 2001. A somewhat shallower image obtained in 1995 allowed us to select out cluster and field objects via their proper motion displacement resulting in remarkably clean color-magnitude diagrams that reach to V = 30, I = 28. The cluster main sequence luminosity function contains very few stars fainter than MV = 15.0, MI = 11.8 which, in both filters, is more than 2 magnitudes brighter than our limit. This is about the faintest luminosity seen among field Population II subdwarfs of the same metallicity. However, there remains a sprinkling of potential cluster stars to lower luminosity all the way down to our limiting magnitudes. These latter objects are significantly redder than any known metal-poor field subdwarf. Comparison with the current generation of theoretical stellar models implies that the masses of the lowest luminosity cluster stars observed are near 0.09 Msun. We derive the mass function of the cluster in our field and find that it is very slowly rising towards the lowest masses with no convincing evidence of a turnover even below 0.1 Msun. The formal slope between 0.65 and 0.09 Msun is alpha = 0.75 (Salpeter of 2.35) with a 99% confidence interval 0.55 - 1.05. A consistency check between these slopes and the number of observed cluster white dwarfs yields a range of possible conclusions, one of which is that we have indeed seen the termination of the white dwarf cooling sequence in M4.Comment: 12 pages, 3 diagrams. To be published in the Astrophysical Journal Letters August 2002. Several minor edits and a different figure 2 from original submissio

Analysis of the Quiescent Low-Mass X-ray Binary Population in Galactic Globular Clusters

Quiescent low-mass X-ray binaries (qLMXBs) containing neutron stars have been identified in several globular clusters using Chandra or XMM X-ray observations, using their soft thermal spectra. We report a complete census of the qLMXB population in these clusters, identifying three additional probable qLMXBs in NGC 6440. We conduct several analyses of the qLMXB population, and compare it with the harder, primarily CV, population of low-luminosity X-ray sources with 10^31<L_X<10^32.5 ergs/s. The radial distribution of our qLMXB sample suggests an average system mass of 1.5^{+0.3}_{-0.2} Msun, consistent with a neutron star and low-mass companion. Spectral analysis reveals that no globular cluster qLMXBs, other than the transient in NGC 6440, require an additional hard power-law component as often observed in field qLMXBs. We identify an empirical lower luminosity limit of 10^32 ergs/s among globular cluster qLMXBs. The bolometric luminosity range of qLMXBs implies (in the deep crustal heating model of Brown and collaborators) low time-averaged mass transfer rates, below the disk stability criterion. The X-ray luminosity functions of the CV populations alone in NGC 6397 and 47 Tuc are shown to differ. The distribution of qLMXBs among globular clusters is consistent with their dynamical formation by either tidal capture or exchange encounters, allowing us to estimate that seven times more qLMXBs than bright LMXBs reside in globular clusters. The distribution of harder sources (primarily CVs) has a weaker dependence upon density than that of the qLMXBs. Finally, we discuss possible effects of core collapse and globular cluster destruction upon X-ray source populations.Comment: Submitted to ApJ. 22 pages, seven figure

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

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Invasive Alien Plant Species—Raising Awareness of a Threat to Biodiversity and Ecological Connectivity (EC) in the Adriatic-Ionian Region

Improving ecological connectivity (EC) within landscapes by establishing corridors and ecological networks has been proposed to counteract the negative effects of habitat fragmentation and climate change on biodiversity. To be functional, ecological networks should be kept free of opportunistic invasive species that can disrupt EC between protected areas and cause biodiversity loss. The present study focused on perennial herbaceous species whose occurrence in the Adriatic-Ionian region has increased in the last two decades, namely common milkweed (Asclepias syriaca), Jerusalem artichoke (Helianthus tuberosus), Japanese knotweed (Reynoutria japonica), Bohemian knotweed (Reynoutria × bohemica), giant hogweed (Heracleum mantegazzianum), giant goldenrod (Solidago gigantea), Canadian goldenrod (Solidago canadensis), and Bermuda buttercup (Oxalis pes-caprae). All species have a high potential to spread in grasslands, abandoned agricultural fields, forest edges, and riparian areas and pose a significant threat to native plant communities and biodiversity. Restoring heavily infested sites is a major challenge because these perennial invaders are very persistent and tend to alter the soil environment in invaded habitats and prevent the recolonization of native plant communities. Therefore, early action should be taken to prevent the spread of these environmental weeds in ecological networks and protected areas with high conservation value. © 2022 by the authors. Licensee MDPI, Basel, Switzerland