Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Aportaciones a los estudios económico-administrativos. Reflexiones teóricas y evidencias empíricas

La economía y la administración están inmersas en el universo de las ciencias sociales, áreas del conocimiento que comprenden dominios diferentes, pero también convergen y se intersectan en un objeto de estudio: las organizacienones y sus agregados (industrias o sectores). Desde una perspectiva social, los estudios económico-administrativos informan sobre cómo hacer eficientes a las organizaciones y competitivos a los sectores con la finalidad de impactar positivamente en la justicia social (por ejemplo: mediante productos de mejor calidad a mejores precios). El auge de este tipo de estudios está extendido a fenómenos clave en el mundo de hoy, tales como: la ventaja competitiva, la innovación, la administración de la cadena de suministros y la administración verde, entre otros.El objetivo de este libro es difundir las aportaciones hechas a los estudios económico-administrativos, ya sea como reflexiones teóricas o a modo de evidencia empírica, pues la conjunción de varias ciencias ayuda a comprender fenómenos complejos mejor que una disciplina en forma aislada. Más que la homogeneidad de teorías o hegemonía de unas sobre otras, la investigación interdisciplinaria construye un acercamiento a la diversidad de puntos de vista: se buscan factores, métodos o lenguajes comunes alrededor de un objeto de estudio (Fernández, 2009; Martínez, 1997), llegándose a conformar una comunidad científica con antecedentes disciplinarios diferentes, pero con cierta unidad, relaciones y acciones recíprocas (Kuhn, 1995). Así, en este texto el objeto de estudio es el funcionamiento e interacción de las organizaciones, como integrantes de los sectores económicos, en los mercados locales y globales. La comunidad científica está conformada por investigadores y egresados del Doctorado en Ciencias Económico-Administrativas, el cual nace en 2006 en la Universidad Autónoma del Estado de México, a cargo de la Dependencia de Educación Superior (DES) Económico-Administrativa

Study of the B−→Λc+Λˉc−K−B^{-} \to \Lambda_{c}^{+} \bar{\Lambda}_{c}^{-} K^{-} decay

The decay $B^{-} \to \Lambda_{c}^{+} \bar{\Lambda}_{c}^{-} K^{-}$ is studied in proton-proton collisions at a center-of-mass energy of $\sqrt{s}=13$ TeV using data corresponding to an integrated luminosity of 5 $\mathrm{fb}^{-1}$ collected by the LHCb experiment. In the $\Lambda_{c}^+ K^{-}$ system, the $\Xi_{c}(2930)^{0}$ state observed at the BaBar and Belle experiments is resolved into two narrower states, $\Xi_{c}(2923)^{0}$ and $\Xi_{c}(2939)^{0}$, whose masses and widths are measured to be $$m(\Xi_{c}(2923)^{0}) = 2924.5 \pm 0.4 \pm 1.1 \,\mathrm{MeV}, \\ m(\Xi_{c}(2939)^{0}) = 2938.5 \pm 0.9 \pm 2.3 \,\mathrm{MeV}, \\ \Gamma(\Xi_{c}(2923)^{0}) = \phantom{000}4.8 \pm 0.9 \pm 1.5 \,\mathrm{MeV},\\ \Gamma(\Xi_{c}(2939)^{0}) = \phantom{00}11.0 \pm 1.9 \pm 7.5 \,\mathrm{MeV},$$ where the first uncertainties are statistical and the second systematic. The results are consistent with a previous LHCb measurement using a prompt $\Lambda_{c}^{+} K^{-}$ sample. Evidence of a new $\Xi_{c}(2880)^{0}$ state is found with a local significance of $3.8\,\sigma$, whose mass and width are measured to be $2881.8 \pm 3.1 \pm 8.5\,\mathrm{MeV}$ and $12.4 \pm 5.3 \pm 5.8 \,\mathrm{MeV}$, respectively. In addition, evidence of a new decay mode $\Xi_{c}(2790)^{0} \to \Lambda_{c}^{+} K^{-}$ is found with a significance of $3.7\,\sigma$. The relative branching fraction of $B^{-} \to \Lambda_{c}^{+} \bar{\Lambda}_{c}^{-} K^{-}$ with respect to the $B^{-} \to D^{+} D^{-} K^{-}$ decay is measured to be $2.36 \pm 0.11 \pm 0.22 \pm 0.25$, where the first uncertainty is statistical, the second systematic and the third originates from the branching fractions of charm hadron decays.Comment: All figures and tables, along with any supplementary material and additional information, are available at https://cern.ch/lhcbproject/Publications/p/LHCb-PAPER-2022-028.html (LHCb public pages

Multidifferential study of identified charged hadron distributions in ZZ-tagged jets in proton-proton collisions at s=\sqrt{s}=13 TeV

Jet fragmentation functions are measured for the first time in proton-proton collisions for charged pions, kaons, and protons within jets recoiling against a $Z$ boson. The charged-hadron distributions are studied longitudinally and transversely to the jet direction for jets with transverse momentum 20 $< p_{\textrm{T}} < 100$ GeV and in the pseudorapidity range $2.5 < \eta < 4$. The data sample was collected with the LHCb experiment at a center-of-mass energy of 13 TeV, corresponding to an integrated luminosity of 1.64 fb$^{-1}$. Triple differential distributions as a function of the hadron longitudinal momentum fraction, hadron transverse momentum, and jet transverse momentum are also measured for the first time. This helps constrain transverse-momentum-dependent fragmentation functions. Differences in the shapes and magnitudes of the measured distributions for the different hadron species provide insights into the hadronization process for jets predominantly initiated by light quarks.Comment: All figures and tables, along with machine-readable versions and any supplementary material and additional information, are available at https://cern.ch/lhcbproject/Publications/p/LHCb-PAPER-2022-013.html (LHCb public pages

Measurement of the ratios of branching fractions R(D∗)\mathcal{R}(D^{*}) and R(D0)\mathcal{R}(D^{0})

The ratios of branching fractions $\mathcal{R}(D^{*})\equiv\mathcal{B}(\bar{B}\to D^{*}\tau^{-}\bar{\nu}_{\tau})/\mathcal{B}(\bar{B}\to D^{*}\mu^{-}\bar{\nu}_{\mu})$ and $\mathcal{R}(D^{0})\equiv\mathcal{B}(B^{-}\to D^{0}\tau^{-}\bar{\nu}_{\tau})/\mathcal{B}(B^{-}\to D^{0}\mu^{-}\bar{\nu}_{\mu})$ are measured, assuming isospin symmetry, using a sample of proton-proton collision data corresponding to 3.0 fb${ }^{-1}$ of integrated luminosity recorded by the LHCb experiment during 2011 and 2012. The tau lepton is identified in the decay mode $\tau^{-}\to\mu^{-}\nu_{\tau}\bar{\nu}_{\mu}$. The measured values are $\mathcal{R}(D^{*})=0.281\pm0.018\pm0.024$ and $\mathcal{R}(D^{0})=0.441\pm0.060\pm0.066$, where the first uncertainty is statistical and the second is systematic. The correlation between these measurements is $\rho=-0.43$. Results are consistent with the current average of these quantities and are at a combined 1.9 standard deviations from the predictions based on lepton flavor universality in the Standard Model.Comment: All figures and tables, along with any supplementary material and additional information, are available at https://cern.ch/lhcbproject/Publications/p/LHCb-PAPER-2022-039.html (LHCb public pages

Pooled analysis of who surgical safety checklist use and mortality after emergency laparotomy

Background: The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods: In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results: Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89⋅6 per cent) compared with that in countries with a middle (753 of 1242, 60⋅6 per cent; odds ratio (OR) 0⋅17, 95 per cent c.i. 0⋅14 to 0⋅21, P &lt; 0⋅001) or low (363 of 860, 42⋅2 percent; OR 0⋅08, 0⋅07 to 0⋅10, P &lt; 0⋅001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference −9⋅4 (95 per cent c.i. −11⋅9 to −6⋅9) per cent; P &lt; 0⋅001), but the relationship was reversed in low-HDI countries (+12⋅1 (+7⋅0 to +17⋅3) per cent; P &lt; 0⋅001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0⋅60, 0⋅50 to 0⋅73; P &lt; 0⋅001). The greatest absolute benefit was seen for emergency surgery in low-and middle-HDI countries. Conclusion: Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries

Étude de la production des J/ψ et D0 dans les collisions PbNe à √sNN = 69 GeV avec l'expérience LHCb

At the end of 2015, the LHCb collaboration has recorded the first collisions induced by the LHC proton and lead beams on a fixed target (gaseous targets). Such data will allow a thorough test, for the first time, of the colour screening mechanism predicted by lattice QCD (when producing a quark-gluon plasma in heavy-ion collisions).The LHCb detector is optimised for heavy flavour measurements. In particular, it allows extremely accurate measurements of bound states such as D mesons, J/ψ, ψ' and χ considered as very sensitive probes for quark-gluon plasma studies.Thanks to the LHCb SMOG system (System for Measuring the Overlap with Gas), initially intended for luminosity measurements, noble gases such as He, Ne, Ar, can be injected inside the vertex detector VELO (Vertex Locator). Acting as ''fixed targets'' for the LHC beams, they give access to proton-nucleus and nucleus-nucleus collisions at an optimal energy to study the phase transition from normal nuclear matter to a quark-gluon plasma. In 2018 LHCb recorded PbNe collisions at a centre-of-mass energy of 69 GeV, making it possible to study the phase transition when comparing the results to the previously recorded pNe collisions at the same centre-of-mass energy.The work presented in this thesis encompasses the totality of the PbNe data treatment and analysis, from the data-taking, to the data quality determination, the signal extraction and the efficiency computation. In addition, in this thesis the development of a software tool to determine the centrality information of heavy-ion collisions is presented. This tool was developed with PbPb and PbNe data, and is available for usage within the LHCb collaboration. These results allow to make a much more in-depth analysis of the results by studying the behaviour of the J/ψ and D0 production not only in a new system, but in different centrality regimes within the same PbNe system.À la fin de l'année 2015, la collaboration LHCb a enregistré les premières collisions induites par les faisceaux de protons et de plomb du LHC sur une cible fixe (cibles gazeuses). Ces données permettront un test approfondi, pour la première fois, du mécanisme d'écrantage du couleur prédit par la QCD sur réseau (lors de la production d'un plasma de quarks et gluons dans des collisions d'ions lourds).Le détecteur LHCb est optimisé pour les mesures de saveurs lourds. En particulier, il permet des mesures extrêmement précises d'états liés tels que les mésons D, J/ψ, ψ' et χ considérés comme des sondes très sensibles pour les études de plasma de quarks et gluons.Grâce au système LHCb SMOG (System for Measuring Overlap with Gas), initialement destiné à la mesure de la luminosité, des gaz rares tels que He, Ne, Ar, peuvent être injectés à l'intérieur du détecteur de vertex VELO (Vertex Locator). Agissant comme des « cibles fixes » pour les faisceaux du LHC, ils donnent accès aux collisions proton-noyau et noyau-noyau à une énergie optimale pour étudier la transition de phase de la matière nucléaire normale à un plasma de quarks et gluons. En 2018, LHCb a enregistré des collisions PbNe à une énergie dans le centre de masse de 69 GeV, ce qui permet d'étudier la transition de phase en comparant les résultats aux collisions pNe précédemment enregistrées à la même énergie dans le centre de masse.Le travail présenté dans cette thèse englobe la totalité du traitement et de l'analyse des données PbNe, de la prise de données à la détermination de la qualité des données, l'extraction du signal et le calcul des efficacités. De plus, dans cette thèse, le développement d'un outil logiciel pour déterminer l'information de centralité des collisions d'ions lourds est présenté. Cet outil a été développé avec des données PbPb et PbNe, et est disponible pour utilisation au sein de la collaboration LHCb. Ces résultats permettent de faire une analyse beaucoup plus approfondie des résultats en étudiant le comportement de la production de J/ψ et D0 non seulement dans un nouveau système, mais dans différents régimes de centralité au sein du même système PbNe

Heavy-flavor production in fixed-target mode with LHCb

LHCb has the unique capability to study collisions of the LHC beams on fixed targets. Internal gas targets of helium, neon and argon have been used so far to collect samples of proton- and Pb-gas collisions corresponding to integrated luminosities up to 0.1 pb−1. Results on open and hidden charm productions will be presented, which can provide crucial constraints on cold nuclear matter effects and nPDF at large x

Étude de la production des J/ψ et D0 dans les collisions PbNe à √sNN = 69 GeV avec l'expérience LHCb

À la fin de l'année 2015, la collaboration LHCb a enregistré les premières collisions induites par les faisceaux de protons et de plomb du LHC sur une cible fixe (cibles gazeuses). Ces données permettront un test approfondi, pour la première fois, du mécanisme d'écrantage du couleur prédit par la QCD sur réseau (lors de la production d'un plasma de quarks et gluons dans des collisions d'ions lourds).Le détecteur LHCb est optimisé pour les mesures de saveurs lourds. En particulier, il permet des mesures extrêmement précises d'états liés tels que les mésons D, J/ψ, ψ' et χ considérés comme des sondes très sensibles pour les études de plasma de quarks et gluons.Grâce au système LHCb SMOG (System for Measuring Overlap with Gas), initialement destiné à la mesure de la luminosité, des gaz rares tels que He, Ne, Ar, peuvent être injectés à l'intérieur du détecteur de vertex VELO (Vertex Locator). Agissant comme des « cibles fixes » pour les faisceaux du LHC, ils donnent accès aux collisions proton-noyau et noyau-noyau à une énergie optimale pour étudier la transition de phase de la matière nucléaire normale à un plasma de quarks et gluons. En 2018, LHCb a enregistré des collisions PbNe à une énergie dans le centre de masse de 69 GeV, ce qui permet d'étudier la transition de phase en comparant les résultats aux collisions pNe précédemment enregistrées à la même énergie dans le centre de masse.Le travail présenté dans cette thèse englobe la totalité du traitement et de l'analyse des données PbNe, de la prise de données à la détermination de la qualité des données, l'extraction du signal et le calcul des efficacités. De plus, dans cette thèse, le développement d'un outil logiciel pour déterminer l'information de centralité des collisions d'ions lourds est présenté. Cet outil a été développé avec des données PbPb et PbNe, et est disponible pour utilisation au sein de la collaboration LHCb. Ces résultats permettent de faire une analyse beaucoup plus approfondie des résultats en étudiant le comportement de la production de J/ψ et D0 non seulement dans un nouveau système, mais dans différents régimes de centralité au sein du même système PbNe.At the end of 2015, the LHCb collaboration has recorded the first collisions induced by the LHC proton and lead beams on a fixed target (gaseous targets). Such data will allow a thorough test, for the first time, of the colour screening mechanism predicted by lattice QCD (when producing a quark-gluon plasma in heavy-ion collisions).The LHCb detector is optimised for heavy flavour measurements. In particular, it allows extremely accurate measurements of bound states such as D mesons, J/ψ, ψ' and χ considered as very sensitive probes for quark-gluon plasma studies.Thanks to the LHCb SMOG system (System for Measuring the Overlap with Gas), initially intended for luminosity measurements, noble gases such as He, Ne, Ar, can be injected inside the vertex detector VELO (Vertex Locator). Acting as ''fixed targets'' for the LHC beams, they give access to proton-nucleus and nucleus-nucleus collisions at an optimal energy to study the phase transition from normal nuclear matter to a quark-gluon plasma. In 2018 LHCb recorded PbNe collisions at a centre-of-mass energy of 69 GeV, making it possible to study the phase transition when comparing the results to the previously recorded pNe collisions at the same centre-of-mass energy.The work presented in this thesis encompasses the totality of the PbNe data treatment and analysis, from the data-taking, to the data quality determination, the signal extraction and the efficiency computation. In addition, in this thesis the development of a software tool to determine the centrality information of heavy-ion collisions is presented. This tool was developed with PbPb and PbNe data, and is available for usage within the LHCb collaboration. These results allow to make a much more in-depth analysis of the results by studying the behaviour of the J/ψ and D0 production not only in a new system, but in different centrality regimes within the same PbNe system

Étude de la production des J/ψ et D0 dans les collisions PbNe à √sNN = 69 GeV avec l'expérience LHCb

At the end of 2015, the LHCb collaboration has recorded the first collisions induced by the LHC proton and lead beams on a fixed target (gaseous targets). Such data will allow a thorough test, for the first time, of the colour screening mechanism predicted by lattice QCD (when producing a quark-gluon plasma in heavy-ion collisions).The LHCb detector is optimised for heavy flavour measurements. In particular, it allows extremely accurate measurements of bound states such as D mesons, J/ψ, ψ' and χ considered as very sensitive probes for quark-gluon plasma studies.Thanks to the LHCb SMOG system (System for Measuring the Overlap with Gas), initially intended for luminosity measurements, noble gases such as He, Ne, Ar, can be injected inside the vertex detector VELO (Vertex Locator). Acting as ''fixed targets'' for the LHC beams, they give access to proton-nucleus and nucleus-nucleus collisions at an optimal energy to study the phase transition from normal nuclear matter to a quark-gluon plasma. In 2018 LHCb recorded PbNe collisions at a centre-of-mass energy of 69 GeV, making it possible to study the phase transition when comparing the results to the previously recorded pNe collisions at the same centre-of-mass energy.The work presented in this thesis encompasses the totality of the PbNe data treatment and analysis, from the data-taking, to the data quality determination, the signal extraction and the efficiency computation. In addition, in this thesis the development of a software tool to determine the centrality information of heavy-ion collisions is presented. This tool was developed with PbPb and PbNe data, and is available for usage within the LHCb collaboration. These results allow to make a much more in-depth analysis of the results by studying the behaviour of the J/ψ and D0 production not only in a new system, but in different centrality regimes within the same PbNe system.À la fin de l'année 2015, la collaboration LHCb a enregistré les premières collisions induites par les faisceaux de protons et de plomb du LHC sur une cible fixe (cibles gazeuses). Ces données permettront un test approfondi, pour la première fois, du mécanisme d'écrantage du couleur prédit par la QCD sur réseau (lors de la production d'un plasma de quarks et gluons dans des collisions d'ions lourds).Le détecteur LHCb est optimisé pour les mesures de saveurs lourds. En particulier, il permet des mesures extrêmement précises d'états liés tels que les mésons D, J/ψ, ψ' et χ considérés comme des sondes très sensibles pour les études de plasma de quarks et gluons.Grâce au système LHCb SMOG (System for Measuring Overlap with Gas), initialement destiné à la mesure de la luminosité, des gaz rares tels que He, Ne, Ar, peuvent être injectés à l'intérieur du détecteur de vertex VELO (Vertex Locator). Agissant comme des « cibles fixes » pour les faisceaux du LHC, ils donnent accès aux collisions proton-noyau et noyau-noyau à une énergie optimale pour étudier la transition de phase de la matière nucléaire normale à un plasma de quarks et gluons. En 2018, LHCb a enregistré des collisions PbNe à une énergie dans le centre de masse de 69 GeV, ce qui permet d'étudier la transition de phase en comparant les résultats aux collisions pNe précédemment enregistrées à la même énergie dans le centre de masse.Le travail présenté dans cette thèse englobe la totalité du traitement et de l'analyse des données PbNe, de la prise de données à la détermination de la qualité des données, l'extraction du signal et le calcul des efficacités. De plus, dans cette thèse, le développement d'un outil logiciel pour déterminer l'information de centralité des collisions d'ions lourds est présenté. Cet outil a été développé avec des données PbPb et PbNe, et est disponible pour utilisation au sein de la collaboration LHCb. Ces résultats permettent de faire une analyse beaucoup plus approfondie des résultats en étudiant le comportement de la production de J/ψ et D0 non seulement dans un nouveau système, mais dans différents régimes de centralité au sein du même système PbNe