Treatment of intracerebral haemorrhage with tranexamic acid : A review of current evidence and ongoing trials

Peer reviewe

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)

Observation of the Λb0→J/ψpπ−\Lambda_b^0 \rightarrow J/\psi p \pi^- decay

The first observation of the Cabibbo-suppressed decay $\Lambda_b^0\rightarrow J/\psi p \pi^-$ is reported using a data sample of proton-proton collisions at 7 and 8 TeV, corresponding to an integrated luminosity of 3 $\rm fb^{-1}$. A prominent signal is observed and the branching fraction relative to the decay mode $\Lambda_b^0\rightarrow J/\psi p K^-$ is determined to be $$\frac{{\cal B}(\Lambda_b^0\rightarrow J/\psi p \pi^-)}{{\cal B}(\Lambda_b^0\rightarrow J/\psi p K^-)}=0.0824\pm0.0025\:(\text{stat})\pm0.0042\:(\text{syst}).$$ A search for direct CP violation is performed. The difference in the CP asymmetries between these two decays is found to be $${\cal A}_{CP}(\Lambda_b^0\rightarrow J/\psi p \pi^-)-{\cal A}_{CP}(\Lambda_b^0\rightarrow J/\psi p K^-)=(+5.7\pm 2.3\:(\text{stat})\pm1.2\:(\text{syst}))\%,$$ which is compatible with CP symmetry at the $2.2\sigma$ level

Precision measurement of the mass and lifetime of the Ξb0\Xi_b^0 baryon

Using a proton-proton collision data sample corresponding to an integrated luminosity of 3 fb$^{-1}$ collected by LHCb at center-of-mass energies of 7 and 8 TeV, about 3800 $\Xi_b^0\to\Xi_c^+\pi^-$, $\Xi_c^+\to pK^-\pi^+$ signal decays are reconstructed. From this sample, the first measurement of the $\Xi_b^0$ baryon lifetime is made, relative to that of the $\Lambda_b^0$ baryon. The mass differences $M(\Xi_b^0)-M(\Lambda_b^0)$ and $M(\Xi_c^+)-M(\Lambda_c^+)$ are also measured with precision more than four times better than the current world averages. The resulting values are $\frac{\tau_{\Xi_b^0}}{\tau_{\Lambda_b^0}} = 1.006\pm0.018\pm0.010$, $M(\Xi_b^0) - M(\Lambda_b^0) = 172.44\pm0.39\pm0.17 MeV/c^2$, $M(\Xi_c^+) - M(\Lambda_c^+) = 181.51\pm0.14\pm0.10 MeV/c^2$, where the first uncertainty is statistical and the second is systematic. The relative rate of $\Xi_b^0$ to $\Lambda_b^0$ baryon production is measured to be $\frac{f_{\Xi_b^0}}{f_{\Lambda_b^0}}\frac{{\cal{B}}(\Xi_b^0\to\Xi_c^+\pi^-)}{{\cal{B}}(\Lambda_b^0\to\Lambda_c^+\pi^-)}\frac{{\cal{B}}(\Xi_c^+\to pK^-\pi^+)}{{\cal{B}}(\Lambda_c^+\to pK^-\pi^+)} = (1.88\pm0.04\pm0.03)\times10^{-2}$, where the first factor is the ratio of fragmentation fractions, $b\to\Xi_b^0$ relative to $b\to\Lambda_b^0$. Relative production rates as functions of transverse momentum and pseudorapidity are also presented.Using a proton-proton collision data sample corresponding to an integrated luminosity of 3  fb-1 collected by LHCb at center-of-mass energies of 7 and 8 TeV, about 3800 Ξb0→Ξc+π-, Ξc+→pK-π+ signal decays are reconstructed. From this sample, the first measurement of the Ξb0 baryon lifetime is made, relative to that of the Λb0 baryon. The mass differences M(Ξb0)-M(Λb0) and M(Ξc+)-M(Λc+) are also measured with precision more than 4 times better than the current world averages. The resulting values are τΞb0τΛb0=1.006±0.018±0.010,M(Ξb0)-M(Λb0)=172.44±0.39±0.17  MeV/c2,M(Ξc+)-M(Λc+)=181.51±0.14±0.10  MeV/c2,where the first uncertainty is statistical and the second is systematic. The relative rate of Ξb0 to Λb0 baryon production is measured to be fΞb0fΛb0B(Ξb0→Ξc+π-)B(Λb0→Λc+π-)B(Ξc+→pK-π+)B(Λc+→pK-π+)=(1.88±0.04±0.03)×10-2,where the first factor is the ratio of fragmentation fractions, b→Ξb0 relative to b→Λb0. Relative production rates as functions of transverse momentum and pseudorapidity are also presented.Using a proton-proton collision data sample corresponding to an integrated luminosity of 3 fb$^{-1}$ collected by LHCb at center-of-mass energies of 7 and 8 TeV, about 3800 $\Xi_b^0\to\Xi_c^+\pi^-$, $\Xi_c^+\to pK^-\pi^+$ signal decays are reconstructed. From this sample, the first measurement of the $\Xi_b^0$ baryon lifetime is made, relative to that of the $\Lambda_b^0$ baryon. The mass differences $M(\Xi_b^0)-M(\Lambda_b^0)$ and $M(\Xi_c^+)-M(\Lambda_c^+)$ are also measured with precision more than four times better than the current world averages. The resulting values are $\frac{\tau_{\Xi_b^0}}{\tau_{\Lambda_b^0}} = 1.006\pm0.018\pm0.010$, $M(\Xi_b^0) - M(\Lambda_b^0) = 172.44\pm0.39\pm0.17 MeV/c^2$, $M(\Xi_c^+) - M(\Lambda_c^+) = 181.51\pm0.14\pm0.10 MeV/c^2$, where the first uncertainty is statistical and the second is systematic. The relative rate of $\Xi_b^0$ to $\Lambda_b^0$ baryon production is measured to be $\frac{f_{\Xi_b^0}}{f_{\Lambda_b^0}}\frac{{\cal{B}}(\Xi_b^0\to\Xi_c^+\pi^-)}{{\cal{B}}(\Lambda_b^0\to\Lambda_c^+\pi^-)}\frac{{\cal{B}}(\Xi_c^+\to pK^-\pi^+)}{{\cal{B}}(\Lambda_c^+\to pK^-\pi^+)} = (1.88\pm0.04\pm0.03)\times10^{-2}$, where the first factor is the ratio of fragmentation fractions, $b\to\Xi_b^0$ relative to $b\to\Lambda_b^0$. Relative production rates as functions of transverse momentum and pseudorapidity are also presented

First measurement of the charge asymmetry in beauty-quark pair production

The difference in the angular distributions between beauty quarks and antiquarks, referred to as the charge asymmetry, is measured for the first time in $b\bar{b}$ pair production at a hadron collider. The data used correspond to an integrated luminosity of 1.0fb$^{-1}$ collected at 7TeV center-of-mass energy in proton-proton collisions with the LHCb detector. The measurement is performed in three regions of the invariant mass of the $b\bar{b}$ system. The results obtained are: \begin{eqnarray} A_{C}^{b\bar{b}}(40 105\,\rm{GeV/c^2}) &=&1.6 \pm 1.7(\rm{stat}) \pm 0.6(\rm{syst})\% \end{eqnarray} where $A_{C}^{b\bar{b}}$ is defined as the asymmetry in the difference in rapidity between jets formed from the beauty quark and antiquark. The beauty jets are required to satisfy $2 20$GeV, and have an opening angle in the transverse plane $\Delta\phi>2.6$rad. These measurements are consistent with the predictions of the Standard Model

Low incidence of SARS-CoV-2, risk factors of mortality and the course of illness in the French national cohort of dialysis patients

International audienceThe aim of this study was to estimate the incidence of COVID-19 disease in the French national population of dialysis patients, their course of illness and to identify the risk factors associated with mortality. Our study included all patients on dialysis recorded in the French REIN Registry in April 2020. Clinical characteristics at last follow-up and the evolution of COVID-19 illness severity over time were recorded for diagnosed cases (either suspicious clinical symptoms, characteristic signs on the chest scan or a positive reverse transcription polymerase chain reaction) for SARS-CoV-2. A total of 1,621 infected patients were reported on the REIN registry from March 16th, 2020 to May 4th, 2020. Of these, 344 died. The prevalence of COVID-19 patients varied from less than 1% to 10% between regions. The probability of being a case was higher in males, patients with diabetes, those in need of assistance for transfer or treated at a self-care unit. Dialysis at home was associated with a lower probability of being infected as was being a smoker, a former smoker, having an active malignancy, or peripheral vascular disease. Mortality in diagnosed cases (21%) was associated with the same causes as in the general population. Higher age, hypoalbuminemia and the presence of an ischemic heart disease were statistically independently associated with a higher risk of death. Being treated at a selfcare unit was associated with a lower risk. Thus, our study showed a relatively low frequency of COVID-19 among dialysis patients contrary to what might have been assumed