Multi-Photon Signals from Composite Models at LHC

We analyze the collider signals of composite scalars that emerge in certain little Higgs models and models of vectorlike confinement. Similar to the decay of the pion into photon pairs, these scalars mainly decay through anomaly-induced interactions into electroweak gauge bosons, leading to a distinct signal with three or more photons in the final state. We study the standard model backgrounds for these signals, and find that the LHC can discover these models over a large range of parameter space with 30 fb$^{-1}$ at 14 TeV. An early discovery at the current 7 TeV run is possible in some regions of parameter space. We also discuss possibilities to measure the spin of the particles in the $\gamma \gamma$ and $Z\gamma$ decay channels.Comment: 18 pages, LaTe

Higher Incidence but Similar Outcomes from Bloodstream Infections in People with Type 2 Diabetes Mellitus: A Retrospective Case-Controlled Analysis

Aims: People with type 2 diabetes mellitus are more susceptible to infections. This study aimed to compare the microbiology, incidence and clinical outcome of bloodstream infections (BSIs) in people with type 2 diabetes and matched controls amongst a cohort of hospital inpatients in the United Kingdom. Methods: A retrospective analysis was conducted on all positive blood cultures obtained over a one-year period, identifying inpatients with type 2 diabetes and BSIs (n = 151). Matched controls were collated from the same cohort. Admission data were obtained from clinical coding. Patient outcomes were analysed in terms of 90-day mortality, length of stay (LOS) and admission rate to high or intensive dependency units (HDU/ICU). Microbial culture and clinical source of infection were compared between groups. Results: Patients with type 2 diabetes comprised 10.6% of admissions but 21.1% (n = 151) of analysed BSIs (OR: 2.27, p < .001). Similar 90-day mortality rates were seen between people with type 2 diabetes (D) and controls (C) (D: 23/151, C: 28/151, p = .54). Mean LOS was also similar (D: 19.8 days, C: 21.1 days p = .62). In both groups, Escherichia coli was the most commonly isolated organism (D: 64/173, C: 55/171) and the urinary tract the most common identified primary site of BSI (D: 47/151, C: 45/151). Conclusions: Whilst inpatients with type 2 diabetes have increased odds of experiencing BSIs, our single-centre study suggests a diagnosis of type 2 diabetes does not necessarily confer a worse outcome

Azithromycin susceptibility testing of Salmonella enterica serovar Typhi: Impact on management of enteric fever

Background Drug-resistant enteric fever is increasingly common in the Indian subcontinent. Correctly determining azithromycin resistance matters where drug-resistant enteric fever is common and oral therapy necessary. Case report In two patients returning from Pakistan to the UK with cephalosporin-resistant Salmonella enterica serovar Typhi, gradient strip testing erroneously indicated azithromycin resistance; the errors were detected by repeat testing and confirmed by whole genome sequencing. Results Both patients were treated with meropenem and, when revised susceptibility results were known, with azithromycin, allowing a switch to oral therapy. Conclusion As cephalosporin resistance becomes more common, azithromycin will be key for treating enteric fever and optimizing practice in susceptibility testing will be crucial. Practitioners should be aware of key steps to minimize error in azithromycin susceptibility testing, and should be alert for possible errors when reported azithromycin resistance is discordant with known prevalence of resistance

Azithromycin susceptibility testing of Salmonella enterica serovar Typhi: Impact on management of enteric fever

Background Drug-resistant enteric fever is increasingly common in the Indian subcontinent. Correctly determining azithromycin resistance matters where drug-resistant enteric fever is common and oral therapy necessary. Case report In two patients returning from Pakistan to the UK with cephalosporin-resistant Salmonella enterica serovar Typhi, gradient strip testing erroneously indicated azithromycin resistance; the errors were detected by repeat testing and confirmed by whole genome sequencing. Results Both patients were treated with meropenem and, when revised susceptibility results were known, with azithromycin, allowing a switch to oral therapy. Conclusion As cephalosporin resistance becomes more common, azithromycin will be key for treating enteric fever and optimizing practice in susceptibility testing will be crucial. Practitioners should be aware of key steps to minimize error in azithromycin susceptibility testing, and should be alert for possible errors when reported azithromycin resistance is discordant with known prevalence of resistance

Cross-sectional study of the prevalence, causes and management of hospital-onset diarrhoea.

BACKGROUND:The National Health Service in England advises hospitals collect data on hospital-onset diarrhoea (HOD). Contemporaneous data on HOD are lacking. AIM:To investigate prevalence, aetiology and management of HOD on medical, surgical and elderly-care wards. METHODS:A cross-sectional study in a volunteer sample of UK hospitals, which collected data on one winter and one summer day in 2016. Patients admitted ≥72 hours were screened for HOD (definition: ≥2 episodes of Bristol Stool Type 5-7 the day before the study, with diarrhoea-onset >48 hours after admission). Data on HOD aetiology and management were collected prospectively. FINDINGS:Data were collected on 141 wards in 32 hospitals (16 acute, 16 teaching). Point-prevalence of HOD was 4.5% (230/5142 patients; 95% CI 3.9-5.0%). Teaching hospital HOD prevalence (5.9%, 95% CI 5.1-6.9%) was twice that of acute hospitals (2.8%, 95% CI 2.1-3.5%; odds ratio 2.2, 95% CI 1.7-3.0). At least one potential cause was identified in 222/230 patients (97%): 107 (47%) had a relevant underlying condition, 125 (54%) were taking antimicrobials, and 195 (85%) other medication known to cause diarrhoea. 9/75 tested patients were Clostridium difficile toxin positive (4%). 80 (35%) patients had a documented medical assessment of the diarrhoea. Documentation of HOD in medical notes correlated with testing for C. difficile (78% of those tested versus 38% not tested, p<0.001). 144 (63%) patients were not isolated following diarrhoea onset. CONCLUSION:HOD is a prevalent symptom affecting thousands of patients across the UK health system each day. Most patients have multiple potential causes of HOD, mainly iatrogenic, but only a third had medical assessment. Most were not tested for C. difficile and were not isolated