Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone

Searches for supersymmetry based on events with b jets and four W bosons in pp collisions at 8 TeV

Five mutually exclusive searches for supersymmetry are presented based on events in which b jets and four W bosons are produced in proton-proton collisions at root s = 8TeV. The data, corresponding to an integrated luminosity of 19.5 fb(-1), were collected with the CMS experiment at the CERN LHC in 2012. The five studies differ in the leptonic signature from the W boson decays, and correspond to all-hadronic, single-lepton, opposite-sign dilepton, same-sign dilepton, and >= 3 lepton final states. The results of the five studies are combined to yield 95% confidence level limits for the gluino and bottom-squark masses in the context of gluino and bottom-squark pair production, respectively. In the limit when the lightest supersymmetric particle is light, gluino and bottom squark masses are excluded below 1280 and 570 GeV, respectively

Koulutusluokitus : Koulutuskoodimuutokset vuonna 1989, Liite 3

A measurement of inclusive ZZ production cross section and constraints on anomalous triple gauge couplings in proton-proton collisions at $\sqrt{s}$ = 8 TeV are presented. A data sample, corresponding to an integrated luminosity of 19.6 inverse-femtobarns was collected with the CMS experiment at the LHC. The measurements are performed in the leptonic decay modes $ZZ \to lll'l'$, where $l = e, \mu$ and $l' = e, \mu, \tau$. The measured total cross section, $\sigma (pp \to ZZ) = 7.7 \pm 0.5 (stat.)^{+0.5}_{-0.4} (syst.) \pm 0.4 (theo.) \pm 0.2 (lum.) pb$ for both Z bosons produced in the mass range $m_Z$ within 60 and 120 GeV, is consistent with standard model predictions. Differential cross sections are measured and well described by the theoretical predictions. The invariant mass distribution of the four-lepton system is used to set limits on anomalous ZZZ and ZZ$\gamma$ couplings at the 95% confidence level: $f_4^Z$ in (-0.004,+0.004), $f_5^Z$ in (-0.005,+0.005), $f_4^\gamma$ in (-0.004,+0.004), and $f_5^\gamma$ in (-0.005,+0.005)

Political participation, diffused governance, and the transformation of democracy : patterns of change

Although democratic governments have introduced a number of institutional reforms in part intended to increase citizens’ political involvement, studies show a continued decline in regular political engagement. This book examines different forms of political participation in democracies, and in what way the delegation of public responsibilities—or, the diffusion of politics—has affected patterns of participation since the 1980s. The book addresses this paradox by directly investigating the impact of institutional changes on citizens’ political participation empirically. It re-analyses patterns of political participation in contemporary democracies, providing an in-depth time series cross-sectional analysis that helps develop a better understanding of how variation in political participation can be explained, both between countries and over time. As such, it develops an institutional theoretical framework which can help to explain levels of participation and shows that, instead of displaying more political apathy, citizens have reallocated or displaced their activities to a broader array of forms of participation.-- Part I: The Changing Democratic System -- 1. Patterns of Change -- 2. The Three Sides of the Coin: Unpacking Political Participation -- 3. Structuring Diffusion: Explaining Levels of Political Participation -- Part II: Patterns of Participation: The Impact of Competence Diffusion -- 4. Participation and Horizontal Diffusion -- 5. Participation and Vertical Diffusion -- 6. Political Participation and Diagonal Diffusion -- Part III: Democracy at the Crossroads? Some Conclusions -- 7. Levels of Political Participation and Multi-Directional Diffusion -- 8. Patterns of Change: Diffused DemocracyPublished version of EUI PhD thesis, 201