Antimicrobials: a global alliance for optimizing their rational use in intra-abdominal infections (AGORA)

Intra-abdominal infections (IAI) are an important cause of morbidity and are frequently associated with poor prognosis, particularly in high-risk patients. The cornerstones in the management of complicated IAIs are timely effective source control with appropriate antimicrobial therapy. Empiric antimicrobial therapy is important in the management of intra-abdominal infections and must be broad enough to cover all likely organisms because inappropriate initial antimicrobial therapy is associated with poor patient outcomes and the development of bacterial resistance. The overuse of antimicrobials is widely accepted as a major driver of some emerging infections (such as C. difficile), the selection of resistant pathogens in individual patients, and for the continued development of antimicrobial resistance globally. The growing emergence of multi-drug resistant organisms and the limited development of new agents available to counteract them have caused an impending crisis with alarming implications, especially with regards to Gram-negative bacteria. An international task force from 79 different countries has joined this project by sharing a document on the rational use of antimicrobials for patients with IAIs. The project has been termed AGORA (Antimicrobials: A Global Alliance for Optimizing their Rational Use in Intra-Abdominal Infections). The authors hope that AGORA, involving many of the world's leading experts, can actively raise awareness in health workers and can improve prescribing behavior in treating IAIs

Measurement of the multi-TeV neutrino cross section with IceCube using Earth absorption

Neutrinos interact only very weakly, so they are extremely penetrating. However, the theoretical neutrino-nucleon interaction cross section rises with energy such that, at energies above 40 TeV, neutrinos are expected to be absorbed as they pass through the Earth. Experimentally, the cross section has been measured only at the relatively low energies (below 400 GeV) available at neutrino beams from accelerators \cite{Agashe:2014kda, Formaggio:2013kya}. Here we report the first measurement of neutrino absorption in the Earth, using a sample of 10,784 energetic upward-going neutrino-induced muons observed with the IceCube Neutrino Observatory. The flux of high-energy neutrinos transiting long paths through the Earth is attenuated compared to a reference sample that follows shorter trajectories through the Earth. Using a fit to the two-dimensional distribution of muon energy and zenith angle, we determine the cross section for neutrino energies between 6.3 TeV and 980 TeV, more than an order of magnitude higher in energy than previous measurements. The measured cross section is $1.30^{+0.21}_{-0.19}$ (stat.) $^{+0.39}_{-0.43}$ (syst.) times the prediction of the Standard Model \cite{CooperSarkar:2011pa}, consistent with the expectation for charged and neutral current interactions. We do not observe a dramatic increase in the cross section, expected in some speculative models, including those invoking new compact dimensions \cite{AlvarezMuniz:2002ga} or the production of leptoquarks \cite{Romero:2009vu}.Comment: Preprint version of Nature paper 10.1038/nature2445

Wses Jerusalem Guidelines For Diagnosis And Treatment Of Acute Appendicitis

Acute appendicitis (AA) is among the most common cause of acute abdominal pain. Diagnosis of AA is challenging; a variable combination of clinical signs and symptoms has been used together with laboratory findings in several scoring systems proposed for suggesting the probability of AA and the possible subsequent management pathway. The role of imaging in the diagnosis of AA is still debated, with variable use of US, CT and MRI in different settings worldwide. Up to date, comprehensive clinical guidelines for diagnosis and management of AA have never been issued. In July 2015, during the 3rd World Congress of the WSES, held in Jerusalem (Israel), a panel of experts including an Organizational Committee and Scientific Committee and Scientific Secretariat, participated to a Consensus Conference where eight panelists presented a number of statements developed for each of the eight main questions about diagnosis and management of AA. The statements were then voted, eventually modified and finally approved by the participants to The Consensus Conference and lately by the board of co-authors. The current paper is reporting the definitive Guidelines Statements on each of the following topics: 1) Diagnostic efficiency of clinical scoring systems, 2) Role of Imaging, 3) Non-operative treatment for uncomplicated appendicitis, 4) Timing of appendectomy and in-hospital delay, 5) Surgical treatment 6) Scoring systems for intra-operative grading of appendicitis and their clinical usefulness 7) Non-surgical treatment for complicated appendicitis: abscess or phlegmon 8) Pre-operative and post-operative antibiotics.1

Study of B Meson Production in p plus Pb Collisions at root s(NN)=5.02 TeV Using Exclusive Hadronic Decays

Peer reviewe

Contributions to the Science of Environmental Impact Assessment: Three Papers on the Arctic Cisco (Coregonus autumnalis) of Northern Alaska

Editor's Introduction -- D. W. Norton; An Assessment of the Colville River Delta Stock of Arctic Cisco--Migrants from Canada? -- B. J. Gallaway, W. B. Griffiths, P. C. Craig, W. J. Gazey, and J. W. Helmericks; Temperature Preference of Juvenile Arctic Cisco (Coregonus autumnalis) From the Alaskan Beaufort Sea -- R. G. Fechhelm, W. H. Neill, and B. J. Gallaway; Modeling Movements and Distribution of Arctic Cisco (Coregonus autumnalis) Relative to Temperature-Salinity Regimes of the Beaufort Sea Near the Waterflood Causeway, Prudhoe Bay, Alaska. -- W. H. Neill, R. G. Fechhelm, B. J. Gallaway, J. D. Bryan, and S. W. Anderson; Notice to Author

Majorana neutrinos and lepton-number-violating signals in top-quark and W-boson rare decays

We discuss rare lepton-number-violating top-quark and W-boson four-body decays to final states containing a same-charge lepton pair, of the same or of different flavors: t -> b W- li^+ lj^+ and W+ -> J J' li^+ lj^+, where i \ne j or i=j and J J' stands for two light jets originating from a (u-bar d) or a (c-bar s) pair. These \Delta L=2 decays are forbidden in the Standard Model and may be mediated by exchanges of Majorana neutrinos. We adopt a model independent approach for the Majorana neutrinos mixing pattern and calculate the branching ratios (BR) for these decays. We find, for example, that for O(1) mixings between heavy and light Majorana neutrinos (not likely but not ruled out) and if at least one of the heavy Majorana neutrinos has a mass of ~100 GeV, then the BR's for these decays are: BR(t -> b li^+ lj^+ W-) ~ 10^{-4} and BR(W+ -> li^+ lj^+ J J') ~ 10^{-7} if m_N ~ 100 GeV and BR(t -> b li^+ lj^+ J J') ~ BR(W+ -> li^+ lj^+ J J') ~ 0.01 if m_N < 50 GeV. Taking into account the present limits on the neutrino mixing parameters, we obtain more realistic values for these BR's: BR(t -> b li^+ lj^+ W-) ~ 10^{-6} and BR(W+ -> li^+ lj^+ J J') ~ 10^{-10} for m_N ~ 100 GeV and BR(t -> b li^+ lj^+ J J') ~ BR(W+ -> li^+ lj^+ J J') ~ 10^{-6} for m_N < 50 GeV.Comment: latex, 7 pages, 2 figures. V2 as published in PL

Semidirect product decomposition of Coxeter groups

Let $(W,S)$ be a Coxeter system, let $S=I \dot{\cup} J$ be a partition of $S$ such that no element of $I$ is conjugate to an element of $J$, let $\widetilde{J}$ be the set of $W_I$-conjugates of elements of $J$ and let $\widetilde{W}$ be the subgroup of $W$ generated by $\widetilde{J}$. We show that $W=\widetilde{W} \rtimes W_I$ and that $(\widetilde{W},\widetilde{J})$ is a Coxeter system.Comment: 28 pages, one table. We have added some comments on parabolic subgroups, double cosets representatives, finite and affine Weyl groups, invariant theory, Solomon descent algebr