A study of CP violation in B-+/- -> DK +/- and B-+/- -> D pi(+/-) decays with D -> (KSK +/-)-K-0 pi(-/+) final states

A first study of CP violation in the decay modes B-+/- -> [(KSK +/-)-K-0 pi(-/+)](D)h(+/-) and B-+/- -> [(KSK +/-)-K-0 pi(-/+)](D)h(+/-), where h labels a K or pi meson and D labels a D-0 or (D) over bar (0) meson, is performed. The analysis uses the LHCb data set collected in pp collisions, corresponding to an integrated luminosity of 3 fb(-1). The analysis is sensitive to the CP-violating CKM phase gamma through seven observables: one charge asymmetry in each of the four modes and three ratios of the charge-integrated yields. The results are consistent with measurements of gamma using other decay modes

Measurement of ϒ production in pp collisions at √s = 2.76 TeV

The production of ϒ(1S), ϒ(2S) and ϒ(3S) mesons decaying into the dimuon final state is studied with the LHCb detector using a data sample corresponding to an integrated luminosity of 3.3 pb−1 collected in proton–proton collisions at a centre-of-mass energy of √s = 2.76 TeV. The differential production cross-sections times dimuon branching fractions are measured as functions of the ϒ transverse momentum and rapidity, over the ranges pT < 15 GeV/c and 2.0 < y < 4.5. The total cross-sections in this kinematic region, assuming unpolarised production, are measured to be σ (pp → ϒ(1S)X) × B ϒ(1S)→μ+μ− = 1.111 ± 0.043 ± 0.044 nb, σ (pp → ϒ(2S)X) × B ϒ(2S)→μ+μ− = 0.264 ± 0.023 ± 0.011 nb, σ (pp → ϒ(3S)X) × B ϒ(3S)→μ+μ− = 0.159 ± 0.020 ± 0.007 nb, where the first uncertainty is statistical and the second systematic

Pedicled SCIA and SIEA Mega Groin Flap-A Staged Reconstructive Approach for Large Forearm Defects

Objective: The pedicled combined superficial circumflex iliac artery and superficial inferior epigastric artery flap has a large vascular territory ideal for coverage of crush-degloving injuries of the upper extremity. We describe our technique of creating a bipedicled flap through a staged inset, first at the wrist and subsequently progressing up the forearm. This process allows primary thinning of the entire flap while facilitating a safe transfer of the flap. Methods: Three patients with crush-degloving injury of the forearm associated with open fractures of the radius and ulnar bones had their defects reconstructed using the aforementioned flap. Patient 3 also had avulsion of the ulnar artery and crush injury of the median and ulnar nerves. Patients 1 and 2 underwent flap delay and training for 1 week prior to inset. Patient 3 did not undergo delay due to the broad-based nature of the flap. The maximal flap size was 25 × 15 cm. The flap was raised thinly until the sufficient length was obtained for the first-stage inset. Over 2 weeks, further elevation and staged inset were performed to maintain uniform thinness and thereby maximize coverage. Results: Complete flap division was accomplished in 3 weeks. All flaps survived with no marginal flap necrosis. Donor sites were closed directly (n = 2) or skin grafted (n = 1). Conclusions: Staged insetting created a bipedicled construct, which allowed primary thinning of the base and bridging portion, thereby allowing maximal use of the entire flap. Maximising the flap was possible because our technique maintained a bipedicled circulation throughout the entire inset process

Routine diagnostics for neural antibodies, clinical correlates, treatment and functional outcome.

To determine frequencies, interlaboratory reproducibility, clinical ratings, and prognostic implications of neural antibodies in a routine laboratory setting in patients with suspected neuropsychiatric autoimmune conditions. Earliest available samples from 10,919 patients were tested for a broad panel of neural antibodies. Sera that reacted with leucine-rich glioma-inactivated protein 1 (LGI1), contactin-associated protein-2 (CASPR2), or the voltage-gated potassium channel (VGKC) complex were retested for LGI1 and CASPR2 antibodies by another laboratory. Physicians in charge of patients with positive antibody results retrospectively reported on clinical, treatment, and outcome parameters. Positive results were obtained for 576 patients (5.3%). Median disease duration was 6 months (interquartile range 0.6-46 months). In most patients, antibodies were detected both in CSF and serum. However, in 16 (28%) patients with N-methyl-D-aspartate receptor (NMDAR) antibodies, this diagnosis could be made only in cerebrospinal fluid (CSF). The two laboratories agreed largely on LGI1 and CASPR2 antibody diagnoses (κ = 0.95). The clinicians (413 responses, 71.7%) rated two-thirds of the antibody-positive patients as autoimmune. Antibodies against the α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor (AMPAR), NMDAR (CSF or high serum titer), γ-aminobutyric acid-B receptor (GABABR), and LGI1 had ≥ 90% positive ratings, whereas antibodies against the glycine receptor, VGKC complex, or otherwise unspecified neuropil had ≤ 40% positive ratings. Of the patients with surface antibodies, 64% improved after ≥ 3 months, mostly with ≥ 1 immunotherapy intervention. This novel approach starting from routine diagnostics in a dedicated laboratory provides reliable and useful results with therapeutic implications. Counseling should consider clinical presentation, demographic features, and antibody titers of the individual patient

Successful programs wanted: exploring the impact of alignment.

Alignment between formulation and implementation of business strategy can be important for achieving successful programmes. The authors have explored developing a programme management alignment theory. Statistical testing suggests that interaction between the study model variables was found to be multidimensional, complex and subtle in influence. They conclude that programmes have both deliberate and emergent strategies requiring design and management to be organised as complex adaptive systems. Programme lifecycle phases of design and transition were often illustrated by an unclear and confusing strategic picture at the outset which makes it difficult to control. Learning was established as an underlying challenge. The study model demonstrated continuous alignment as an essential attribute contributing towards successful delivery. This requires programme design and structure to adopt an adaptive posture