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

Identification of beauty and charm quark jets at LHCb

Identification of jets originating from beauty and charm quarks is important for measuring Standard Model processes and for searching for new physics. The performance of algorithms developed to select b- and c-quark jets is measured using data recorded by LHCb from proton-proton collisions at root s = 7TeV in 2011 and at root s = 8TeV in 2012. The efficiency for identifying a b (c) jet is about 65%(25%) with a probability for misidentifying a light-parton jet of 0.3% for jets with transverse momentum pT > 20GeV and pseudorapidity 2 : 2 < eta < 4.2. The dependence of the performance on the pT and eta of the jet is also measured

Measurement of the CP-violating phase beta in B-0 -> J/psi pi(+)pi(-) decays and limits on penguin effects

Time-dependent CP violation is measured in the (B-0) over bar -> J/psi pi(+)pi(-) p-channel for each pi(+)pi(-) resonant final state using data collected with an integrated luminosity of 3.0 fb(-1) in pp collisions using the LHCb detector. The final state with the largest rate, J/psi rho(0)(770), is used to measure the CP-violating angle 2 beta(eff) to be (41.7 +/- 9.6(-6.3)(+2.8)).. This result can be used to limit the size of penguin amplitude contributions to CPviolation measurements in, for example, (B-0) over bar -> J/psi pi(+)pi(-) decays. Assuming approximate SU(3) flavour symmetry and neglecting higher order diagrams, the shift in the CP-violating phase phi(s) limited to be within the interval [-1.05 degrees, + 1.18 degrees] at 95% confidence level. Changes to the limit due to SU(3) symmetry breaking effects are also discussed. (C) 2015 The Authors. Published by Elsevier B.V

Measurement of the lifetime of the B-c(+) meson using the B-c(+) -> J/psi pi(+) decay mode

The difference in total widths between the B-c(+) and B+ mesons is measured using a data sample corresponding to an integrated luminosity of 3.0 fb(-1) collected by the LHCb experiment in 7 and 8 TeV centre-of-mass energy proton-proton collisions at the LHC. Through the study of the time evolution of B-c(+) -> J/psi pi(+) and B+ -> J/psi K+ decays, the width difference is measured to be Delta Gamma = Gamma(Bc+) - Gamma(Bc+) = 4.46 +/- 0.14 +/- 0.07 mm(-1) c, where the first uncertainty is statistical and the second systematic. The known lifetime of the B+ meson is used to convert this to a precise measurement of the B-c(+) clifetime, tau(Bc+) = 513.4 +/- 11.0 +/- 5.7 fs, where the first uncertainty is statistical and the second is systematic. (C) 2015 The Authors. Published by Elsevier B.V

Observation of the decay (B)over-bar(s)(0) -> psi(2S)K+pi(-)

The decay (B) over bar (0)(s) -> psi(2S)K+pi(-) is observed using a data set corresponding to an integrated luminosity of 3.0 fb(-1) collected by the LHCb experiment in pp collisions at centre-of-mass energies of 7 and 8 TeV. The branching fraction relative to the B-0 -> psi(2S)K+pi(-) decay mode is measured to be B((B) over bar (0)(s) -> psi(2S)K+pi(-))/B(B-0 -> psi(2S)K+pi(-)) = 5.38 +/- 0.36 (stat) +/- 0.22 (syst) +/- 0.31 (f(s)/f(d)) %, where f(s)/f(d) indicates the uncertainty due to the ratio of probabilities for a b quark to hadronise into a B-s(0) or B-0 meson. Using an amplitude analysis, the fraction of decays proceeding via an intermediate K*(892)(0) meson is measured to be 0.645 +/- 0.049 (stat) +/- 0.049 (syst) and its longitudinal polarisation fraction is 0.524 +/- 0.056 (stat) +/- 0.029 (syst). The relative branching fraction for this component is determined to be B((B) over bar (0)(s) -> psi(2S)K*(892)(0))/B(B-0 -> psi(2S)K*(892)(0)) = 5.58 +/- 0.57 (stat) +/- 0.40 (syst) +/- 0.32 (f(s)/f(d)) %. In addition, the mass splitting between the B-s(0) and B-0 mesons is measured as M(B-s(0)) - M(B-0) = 87.45 +/- 0.44 (stat) +/- 0.09 (syst) MeV/c(2). (C) 2015 CERN for the benefit of the LHCb Collaboration. Published by Elsevier B.V. This is an open access article under the CC BY licens

B flavour tagging using charm decays at the LHCb experiment

An algorithm is described for tagging the flavour content at production of neutral B mesons in the LHCb experiment. The algorithm exploits the correlation of the flavour of a B meson with the charge of a reconstructed secondary charm hadron from the decay of the other b hadron produced in the proton-proton collision. Charm hadron candidates are identified in a number of fully or partially reconstructed Cabibbo-favoured decay modes. The algorithm is calibrated on the self-tagged decay modes B+ -> J/psi K+ and B-0 -> J/psi K*(0) using 3.0fb(-1) of data collected by the LHCb experiment at pp centre-of-mass energies of 7TeV and 8TeV. Its tagging power on these samples of B -> J/psi X decays is (0.30 +/- 0.01 +/- 0.01) %

Study of the rare B-s(0) and B-0 decays into the pi(+) pi(-) mu(+) mu(-) final state

A search for the rare decays B-s(0) -> pi(+) pi-mu(+) mu-and B-0 -> pi(+) pi-mu(+) mu-is performed in a data set corresponding to an integrated luminosity of 3.0 fb(-1) collected by the LHCb detector in proton-proton collisions at centre-of-mass energies of 7 and 8 TeV. Decay candidates with pion pairs that have invariant mass in the range 0.5-1.3GeV/c(2) and with muon pairs that do not originate from a resonance are considered. The first observation of the decay B-s(0) -> pi(+) pi-mu(+) mu- and the first evidence of the decay B-0 -> pi(+) pi-mu(+) mu-are obtained and the branching fractions, restricted to the dipion-mass range considered, are measured to be B(B-s(0) -> pi(+) pi-mu(+) mu(-)) =(8.6 +/- 1.5(stat) +/- 0.7(syst) +/- 0.7 (norm)) x 10(-8) and B(B-0 -> pi(+) pi-mu(+) mu(-)) =(2.11 +/- 0.51(stat) +/- 0.15(syst) +/- 0.16(norm)) x10(-8), where the third uncertainty is due to the branching fraction of the decay B-0. -> J/Psi(mu(+) mu(-)) K*(892)(0)(-> K+ pi(-)), used as a normalisation. (C) 2015 The Authors. Published by Elsevier B.V