Association of mechanical bowel preparation with oral antibiotics and anastomotic leak following left sided colorectal resection:an international, multi-centre, prospective audit

Introduction: The optimal bowel preparation strategy to minimise the risk of anastomotic leak is yet to be determined. This study aimed to determine whether oral antibiotics combined with mechanical bowel preparation (MBP+Abx) was associated with a reduced risk of anastomotic leak when compared to mechanical bowel preparation alone (MBP) or no bowel preparation (NBP). Methods: A pre-planned analysis of the European Society of Coloproctology (ESCP) 2017 Left Sided Colorectal Resection audit was performed. Patients undergoing elective left sided colonic or rectal resection with primary anastomosis between 1 January 2017 and 15 March 2017 by any operative approach were included. The primary outcome measure was anastomotic leak. Results: Of 3676 patients across 343 centres in 47 countries, 618 (16.8%) received MBP+ABx, 1945 MBP (52.9%) and 1099 patients NBP (29.9%). Patients undergoing MBP+ABx had the lowest overall rate of anastomotic leak (6.1%, 9.2%, 8.7% respectively) in unadjusted analysis. After case-mix adjustment using a mixed-effects multivariable regression model, MBP+Abx was associated with a lower risk of anastomotic leak (OR 0.52, 0.30–0.92, P = 0.02) but MBP was not (OR 0.92, 0.63–1.36, P = 0.69) compared to NBP. Conclusion: This non-randomised study adds ‘real-world’, contemporaneous, and prospective evidence of the beneficial effects of combined mechanical bowel preparation and oral antibiotics in the prevention of anastomotic leak following left sided colorectal resection across diverse settings. We have also demonstrated limited uptake of this strategy in current international colorectal practice

First MATISSE L-band observations of HD 179218: is the inner 10 au region rich in carbon dust particles?

Stars and planetary system

Revivalism, Bible Societies, and Tract Societies in the Kingdom of Hungary: A Multi-Ethnic, Multi-Cultural, and Multi-Denominational Work for Spreading the Good News of Jesus Christ

Abstract The current research paper seeks to investigate how Evangelicals and Pietist, the most fervent of Protestants sought to ‘educate’ the masses outside the educational framework of ecclesiastical and state structures within the Hungarian Kingdom. More specifically the study intends to offer a concise overview of the history of Protestants who spread the gospel through the distribution of affordable Bibles, New Testaments and Christian tracts. It shows how various denominations worked together as well as directs attention to their theological outlook which transcended ethnic boundaries. It is a well-known fact in mission and church history that such undertakings were carried out to stir revivalism. The study also throws light on how influential role the Scottish Mission as well as Archduchess Maria Dorothea played in stirring revivalism through the aforementioned means. The history of these kinds of endeavours, especially that of the most significant ones like the work of the British and Foreign Bible Society and Religious Tract Society has not been treated adequately by historians of religion and education, intellectual historians and social historians. This research output is a contribution to give an account of the multi-ethnic and transdenominational work of Hungarians, Jews, Germans, Slovaks and Romanians working for a common goal.</jats:p

New method to predict the surface tension of complex synthetic and biological polyelectrolyte/surfactant mixtures

Although the surface tension of complex mixtures determines the fate of many important natural processes, the property is notoriously difficult to interpret. Here we announce a new method that successfully predicts the surface tension of two synthetic and one biological polyelectrolyte/surfactant mixtures in the phase-separation region after dynamic changes in the bulk phase behavior have reached completion. The approach is based on the nonequilibrium framework of a lack of colloidal stability of bulk complexes in compositions around the charge match point of the oppositely charged components and requires as input parameters only the surface tension isotherm of the pure surfactant and some bulk measurements of the mixtures; no surface measurements of the mixtures are required. The complexity of the problem is reduced to a single empirical equation. This simplification in our understanding of the surface properties of strongly interacting mixtures involving macromolecules can lead to the optimization of applications involving synthetic polymers and biomacromolecules such as DNA at surfaces.</p

Disks around FUor-type young eruptive stars with ALMA

AbstractA long-standing problem of the general paradigm of low-mass star formation is the “luminosity problem”: protostars are less luminous than theoretically predicted. One possible solution is that the accretion process is episodic. FU Orionis-type stars (FUors) are thought to be the visible examples for objects in the high accretion state and it is still debated what physical mechanism triggers the phenomenon. For many of these objects their disk properties are still largely unknown so we conducted a deep, high spatial resolution (down to 20 au) ALMA Band 6 (1.3 mm) dust continuum survey of a sub-sample of known FUors. Here we present preliminary results of our survey, including the mass, size and spectral slope of each disk.</jats:p