SummaryBackgroundSurgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world.MethodsThis international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231.FindingsBetween Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p<0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p<0·001).InterpretationCountries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication.FundingDFID-MRC-Wellcome Trust Joint Global Health Trial Development Grant,...

We report observations of the Type Iax supernova (SN Iax) 2012Z at optical and near-infrared wavelengths from immediately after the explosion until ∼ 260 days after the maximum luminosity using the Optical and Infrared Synergetic Telescopes for Education and Research (OISTER) Targetof-Opportunity (ToO) program and the Subaru telescope. We found that the near-infrared (NIR) light curve evolutions and color evolutions are similar to those of SNe Iax 2005hk and 2008ha. The NIR absolute magnitudes (M J ∼ −18.1 mag and M H ∼ −18.3 mag) and the rate of decline of the light curve (∆ m 15 (B)= 1.6 ± 0.1 mag) are very similar to those of SN 2005hk (M J ∼ −17.7 mag, M H ∼−18.0 mag, and ∆ m 15 (B)∼ 1.6 mag), yet differ significantly from SNe 2008ha and 2010ae (M J ∼ −14 − −15 mag and ∆ m 15 (B)∼ 2.4 − 2.7 mag). The estimated rise time is 12.0 ± 3.0 days,which is significantly shorter than that of SN 2005hk or any other Ia SNe. The rapid rise indicates that the 56 Ni distribution may extend into the outer layer or that the effective opacity may be lower than that in normal SNe Ia. The late-phase spectrum exhibits broader emission lines than those of SN 2005hk by a factor of 6-8. Such high velocities of the emission lines indicate that the density profile of the inner ejecta extends more than that of SN 2005hk. We argue that the most favored explosion scenario is a 'failed deflagration' model, although the pulsational delayed detonations is not excluded. Subject headings: supernovae: general -supernovae: individual (SN 2012Z) -supernovae: individual (SNe 2005hk)

Binary and multiple stellar systems are numerous in our solar neighborhood with 80 per cent of the solar-type stars being members of systems with high order multiplicity. The Contact Binaries Towards Merging (CoBiToM) Project is a programme that focuses on contact binaries and multiple stellar systems, as a key for understanding stellar nature. The goal is to investigate stellar coalescence and merging processes, as the final state of stellar evolution of low-mass contact binary systems. Obtaining observational data of approximately 100 eclipsing binaries and multiple systems and more than 400 archival systems, the programme aspires to give insights for their physical and orbital parameters and their temporal variations, e.g. the orbital period modulation, spot activity etc. Gravitational phenomena in multiple-star environments will be linked with stellar evolution. A comprehensive analysis will be conducted, in order to investigate the possibility of contact binaries to host planets, as well as the link between inflated hot Jupiters and stellar mergers. The innovation of CoBiToM Project is based on a multi-method approach and a detailed investigation, that will shed light for the first time on the origin of stellar mergers and rapidly rotating stars. In this work we describe the scientific rationale, the observing facilities to be used and the methods that will be followed to achieve the goals of CoBiToM Project and we present the first results as an example of the current research on evolution of contact binary systems.

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Ultra-short orbital period contact binaries (Porb &lt; 0.26 d) host some of the smallest and least massive stars. These systems are faint and rare, and it is believed that they have reached a contact configuration after several Gyrs of evolution via angular momentum loss, mass transfer and mass loss through stellar wind processes. This study is conducted in the frame of Contact Binaries Towards Merging (CoBiToM) Project and presents the results from light curve and orbital analysis of 30 ultra-short orbital period contact binaries, with the aim to investigate the possibility of them being red nova progenitors, eventually producing merger events. Approximately half of the systems exhibit orbital period modulations, as a result of mass transfer or mass loss processes. Although they are in contact, their fill-out factor is low (less than 30 per cent), while their mass ratio is larger than the one in longer period contact binaries. The present study investigates the orbital stability of these systems and examines their physical and orbital parameters in comparison to those of the entire sample of known and well-studied contact binaries, based on combined spectroscopic and photometric analysis. It is found that ultra-short orbital period contact binaries have very stable orbits, while very often additional components are gravitationally bound in wide orbits around the central binary system. We confirmed that the evolution of such systems is very slow, which explains why the components of ultra-short orbital period systems are still Main Sequence stars after several Gyrs of evolution.

Objectives To investigate the predictive value of different immunological markers on treatment outcomes after bacille Calmette–Guérin (BCG) induction in high‐risk non‐muscle‐invasive bladder cancer (NMIBC). Patients and Methods Patients who underwent transurethral resection of bladder tumour for NMIBC were assessed for study eligibility. Urine and blood samples were taken from patients at baseline (immediately before first dose of induction) and after induction (4 h after last [sixth] dose). Urine samples were evaluated for interleukin (IL)‐2 and IL‐10 by solid‐phase enzyme‐linked immunosorbent assay. Blood samples were evaluated for tumour necrosis factor α (TNF‐α), cytotoxic T‐lymphocyte antigen 4 (CTLA‐4) and transcription factors (TFs) (GATA‐binding protein 3 [GATA3], T‐box expressed in T cells [T‐bet], and forkhead box protein 3 [FoxP3]) using quantitative reverse transcriptase‐polymerase chain reaction analysis. Change pattern and fold change of each evaluable marker was assessed in relation to different treatment outcomes (initial complete response [ICR]/recurrence/progression). Results Between July 2013 and May 2019, 204 patients were included. Among evaluable markers, urinary IL‐2 and serum TNF‐α increased in all patients, serum CTLA‐4 and FoxP3+ showed a predominant decreased pattern in 188 (92.2%) and 192 (94.1%) patients, respectively. An ICR was achieved in 186 (91.2%) patients. Serum TNF‐α fold change and urinary IL‐10 change pattern were significantly associated with an ICR (P = 0.001 and P = 0.03, respectively). At a median (range) follow‐up of 37 (20–88) months, 104 (56%) patients developed recurrence. Urinary IL‐10, serum CTLA‐4, T‐bet+, FoxP3+ change patterns and GATA3+/T‐bet+ ratio were significantly associated with tumour recurrence (P = 0.001, P = 0.001, P = 0.02, P = 0.009 and P = 0.001, respectively). Tumour progression occurred in 34 (18.3%) patients. Urinary IL‐10, serum CTLA‐4, serum T‐bet+ change patterns and GATA3+/T‐bet+ ratio were independent predictors of tumour progression (P = 0.001, P = 0.001, P = 0.02 and P = 0.001, respectively). Conclusions Urinary IL‐10 and serum TNF‐α can significantly predict ICR. Moreover, change pattern of urinary IL‐10, serum CTLA‐4, TFs (GATA3, T‐bet and FoxP3) and GATA3+/T‐bet+ ratio after BCG induction can independently predict further BCG response. These markers could be implemented in clinical practice when management options are discussed or in systems with severe BCG shortage.

AB S T R AC TNGC7789 is an intermediate-age open cluster with an age that is similar to the mean age of contact binary stars. V12 is a bright UMa-type binary star with an orbital period of 0.397day. The first complete light curves of V12 in V, R, and I bands are presented and analyzed with the W-D (Wilson and Devinney) method. The results shows that V12 is an intermediate-contact binary ( f = 43(±2.2)%) with a mass ratio of 3.848, and i t is a W-type contact binary where the less massive component is slightly hotter than the more massive one. The asymmetry of the light curves are explained by the presence of a dark spot on the more massive component. The derived orbital inclination ( i = 83.6 ) indicates that i t is a total eclipsing binary, which suggests that the determined parameters are reliable. The orbital period may show a long-term increase at a rate of P = +2.48(±0.17) × 10 days/year that reveals a rapid mass transfer from the less massive component to the more massive one. However, more observations are needed to confirm this conclusion. The presence of an intermediate-contact binary in an intermediate-age open cluster may suggest that some contact binaries have a very short pre-contact timescale. The presence of a third body or/and stellar collision may help to shorten the pre-contact evolution. Key laboratory of the structure and evolution celestial bodies, Chinese Academy of Sciences,