Potentiel de l’archéointensité en datation archéomagnétique au haut MoyenÂge et au premier millénaire av. J.-C. : illustration avec cinq fours de Cumes, Mégara Hyblaea et Incoronata (Italie)

International audienceCette communication présente les datations archéomagnétiques de cinq fours mis au jour sur les sites de Megara Hyblaea (Sicile), d’Incoronata (Basilicate) et de Cumes (Campanie). Le contexte archéologique place le fonctionnement de ces fours à l’époque grecque (premier millénaire av. J.-C.) à Mégara Hyblaea et Incoronata et au haut Moyen-Âge à Cumes. Au moins 15 prélèvements par structure ont été effectués suivant la méthode du chapeau de plâtre ou par carottage des parois. Les archéodirections moyennes ont été déterminées après désaimantation thermique et par champ alternatif et les archéointensités par le protocole de Thellier-Thellier avec corrections d’anisotropie et de vitesse de refroidissement. La datation archéomagnétique de ces structures illustre la difficulté du choix du référentiel en Italie méridionale. En effet, les courbes de variation séculaire italiennes demeurent trop imprécises ou incomplètes du fait d’un nombre insuffisant de données de référence (Tema et al., 2006 ; 2013). L’utilisation des courbes d’Europe occidentale, construites à partir d’archéointensités de référence de qualité, est discutable en raison de l’éloignement par rapport au point de référence Paris (1300 à 1600 km). Les référentiels d’Europe de l’Est sont plus proches (800 km), mais le faible nombre d’archéointensités de référence de qualité ne permet pas une datation fiable. Aussi, l’alternative la plus fiable aux courbes italiennes s’avère le modèle européen SCHA.DIF.3k construit après sélection des données d’intensité suivant le protocole de mesure au laboratoire et le nombre d’échantillons (Pavon-Carrasco et al., en révision). Les résultats mettent en évidence le potentiel de datation de l’archéointensité grâce à sa forte variation séculaire au haut Moyen-Âge et au premier millénaire av. J.-C. (Gomez-Paccard et al., 2012 ; Hervé et al., 2013). L’archéointensité affine en effet de 20 à 30% la datation obtenue avec l’archéodirection seule. De nouvelles intensités de référence en Europe permettraient d’optimiser encore ce potentiel

2700 years of Mediterranean environmental change in central Italy : a synthesis of sedimentary and cultural records to interpret past impacts of climate on society

Abrupt climate change in the past is thought to have disrupted societies by accelerating environmental degradation, potentially leading to cultural collapse. Linking climate change directly to societal disruption is challenging because socioeconomic factors also play a large role, with climate being secondary or sometimes inconsequential. Combining paleolimnologic, historical, and archaeological methods provides for a more secure basis for interpreting the past impacts of climate on society. We present pollen, non-pollen palynomorph, geochemical, paleomagnetic and sedimentary data from a high-resolution 2700 yr lake sediment core from central Italy and compare these data with local historical documents and archeological surveys to reconstruct a record of environmental change in relation to socioeconomic history and climatic fluctuations. Here we document cases in which environmental change is strongly linked to changes in local land management practices in the absence of clear climatic change, as well as examples when climate change appears to have been a strong catalyst that resulted in significant environmental change that impacted local communities. During the Imperial Roman period, despite a long period of stable, mild climate, and a large urban population in nearby Rome, our site shows only limited evidence for environmental degradation. Warm and mild climate during the Medieval Warm period, on the other hand, led to widespread deforestation and erosion. The ability of the Romans to utilize imported resources through an extensive trade network may have allowed for preservation of the environment near the Roman capital, whereas during medieval time, the need to rely on local resources led to environmental degradation. Cool wet climate during the Little Ice Age led to a breakdown in local land use practices, widespread land abandonment and rapid reforestation. Our results present a high-resolution regional case study that explores the effect of climate change on society for an under-documented region of Europe. (C) 2015 Elsevier Ltd. All rights reserved

2700 years of Mediterranean environmental change in central Italy: a synthesis of sedimentary and cultural records to interpret past impacts of climate on society

Abrupt climate change in the past is thought to have disrupted societies by accelerating environmental degradation, potentially leading to cultural collapse. Linking climate change directly to societal disruption is challenging because socioeconomic factors also play a large role, with climate being secondary or sometimes inconsequential. Combining paleolimnologic, historical, and archaeological methods provides for a more secure basis for interpreting the past impacts of climate on society. We present pollen, nonpollen palynomorph, geochemical, paleomagnetic and sedimentary data from a high-resolution 2700 yr lake sediment core from central Italy and compare these data with local historical documents and archeological surveys to reconstruct a record of environmental change in relation to socioeconomic history and climatic fluctuations. Here we document cases in which environmental change is strongly linked to changes in local land management practices in the absence of clear climatic change, as well as examples when climate change appears to have been a strong catalyst that resulted in significant environmental change that impacted local communities. During the Imperial Roman period, despite a long period of stable, mild climate, and a large urban population in nearby Rome, our site shows only limited evidence for environmental degradation. Warm and mild climate during the Medieval Warm period, on the other hand, led to widespread deforestation and erosion. The ability of the Romans to utilize imported resources through an extensive trade network may have allowed for preservation of the environment near the Roman capital, whereas during medieval time, the need to rely on local resources led to environmental degradation. Cool wet climate during the Little Ice Age led to a breakdown in local land use practices, widespread land abandonment and rapid reforestation. Our results present a highresolution regional case study that explores the effect of climate change on society for an underdocumented region of Europe

Patients with Crohn's disease have longer post-operative in-hospital stay than patients with colon cancer but no difference in complications' rate

BACKGROUNDRight hemicolectomy or ileocecal resection are used to treat benign conditions like Crohn's disease (CD) and malignant ones like colon cancer (CC).AIMTo investigate differences in pre- and peri-operative factors and their impact on post-operative outcome in patients with CC and CD.METHODSThis is a sub-group analysis of the European Society of Coloproctology's prospective, multi-centre snapshot audit. Adult patients with CC and CD undergoing right hemicolectomy or ileocecal resection were included. Primary outcome measure was 30-d post-operative complications. Secondary outcome measures were post-operative length of stay (LOS) at and readmission.RESULTSThree hundred and seventy-five patients with CD and 2,515 patients with CC were included. Patients with CD were younger (median = 37 years for CD and 71 years for CC (P < 0.01), had lower American Society of Anesthesiology score (ASA) grade (P < 0.01) and less comorbidity (P < 0.01), but were more likely to be current smokers (P < 0.01). Patients with CD were more frequently operated on by colorectal surgeons (P < 0.01) and frequently underwent ileocecal resection (P < 0.01) with higher rate of de-functioning/primary stoma construction (P < 0.01). Thirty-day post-operative mortality occurred exclusively in the CC group (66/2515, 2.3%). In multivariate analyses, the risk of post-operative complications was similar in the two groups (OR 0.80, 95%CI: 0.54-1.17; P = 0.25). Patients with CD had a significantly longer LOS (Geometric mean 0.87, 95%CI: 0.79-0.95; P < 0.01). There was no difference in re-admission rates. The audit did not collect data on post-operative enhanced recovery protocols that are implemented in the different participating centers.CONCLUSIONPatients with CD were younger, with lower ASA grade, less comorbidity, operated on by experienced surgeons and underwent less radical resection but had a longer LOS than patients with CC although complication's rate was not different between the two groups

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

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

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

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