Erratum to: 36th International Symposium on Intensive Care and Emergency Medicine

[This corrects the article DOI: 10.1186/s13054-016-1208-6.]

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical 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. Methods: This 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. Findings: Between 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). Interpretation: Countries 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

Sensitivity of the Cherenkov Telescope Array to the gamma-ray emission from neutrino sources detected by IceCube

Gamma-ray observations of the astrophysical neutrino sources are fundamentally important for understanding the underlying neutrino production mechanism. We investigate the Cherenkov Telescope Array (CTA) ability to detect the very-high-energy (VHE) gamma-ray counterparts to the neutrino-emitting Active Galaxies. The CTA performance under different configurations and array layouts is computed based on the neutrino and gamma-ray simulations of steady and transient types of sources, assuming that the neutrino events are detected with the IceCube neutrino telescope. The CTA detection probability is calculated for both CTA sites taking into account the visibility constraints. We find that, under optimal observing conditions, CTA could observe the VHE gamma-ray emission from at least 3 neutrino events per year

Prospects for γ-ray observations of the Perseus galaxy cluster with the Cherenkov Telescope Array

Galaxy clusters are expected to be both dark matter (DM) reservoirs and storage rooms for the cosmic-ray protons (CRp) that accumulate along the cluster’s formation history. Accordingly, they are excellent targets to search for signals of DM annihilation and decay at γ-ray energies and are predicted to be sources of large-scale γ-ray emission due to hadronic interactions in the intracluster medium (ICM). In this paper, we estimate the sensitivity of the Cherenkov Telescope Array (CTA) to detect diffuse γ-ray emission from the Perseus galaxy cluster. We first perform a detailed spatial and spectral modelling of the expected signal for both the DM and the CRp components. For each case, we compute the expected CTA sensitivity accounting for the CTA instrument response functions. The CTA observing strategy of the Perseus cluster is also discussed. In the absence of a diffuse signal (non-detection), CTA should constrain the CRp to thermal energy ratio X500 within the characteristic radius R500 down to about X500 &lt; 3 × 10−3, for a spatial CRp distribution that follows the thermal gas and a CRp spectral index αCRp = 2.3. Under the optimistic assumption of a pure hadronic origin of the Perseus radio mini-halo and depending on the assumed magnetic field profile, CTA should measure αCRp down to about ∆αCRp ≃ 0.1 and the CRp spatial distribution with 10% precision, respectively. Regarding DM, CTA should improve the current ground-based γ-ray DM limits from clusters observations on the velocity-averaged annihilation cross-section by a factor of up to ∼ 5, depending on the modelling of DM halo substructure. In the case of decay of DM particles, CTA will explore a new region of the parameter space, reaching models with τχ &gt; 1027 s for DM masses above 1 TeV. These constraints will provide unprecedented sensitivity to the physics of both CRp acceleration and transport at cluster scale and to TeV DM particle models, especially in the decay scenario

Sensitivity of the Cherenkov Telescope Array for probing cosmology and fundamental physics with gamma-ray propagation

The Cherenkov Telescope Array (CTA), the new-generation ground-based observatory for $\gamma$-ray astronomy, provides unique capabilities to address significant open questions in astrophysics, cosmology, and fundamental physics. We study some of the salient areas of $\gamma$-ray cosmology that can be explored as part of the Key Science Projects of CTA, through simulated observations of active galactic nuclei (AGN) and of their relativistic jets. Observations of AGN with CTA will enable a measurement of $\gamma$-ray absorption on the extragalactic background light with a statistical uncertainty below 15% up to a redshift $z=2$ and to constrain or detect $\gamma$-ray halos up to intergalactic-magnetic-field strengths of at least 0.3pG. Extragalactic observations with CTA also show promising potential to probe physics beyond the Standard Model. The best limits on Lorentz invariance violation from $\gamma$-ray astronomy will be improved by a factor of at least two to three. CTA will also probe the parameter space in which axion-like particles could constitute a significant fraction, if not all, of dark matter. We conclude on the synergies between CTA and other upcoming facilities that will foster the growth of $\gamma$-ray cosmology

Prospects for γ-ray observations of the Perseus galaxy cluster with the Cherenkov Telescope Array

Galaxy clusters are expected to be dark matter (DM) reservoirs and storage rooms for the cosmic-ray protons (CRp) that accumulate along the cluster's formation history. Accordingly, they are excellent targets to search for signals of DM annihilation and decay at gamma-ray energies and are predicted to be sources of large-scale gamma-ray emission due to hadronic interactions in the intracluster medium. We estimate the sensitivity of the Cherenkov Telescope Array (CTA) to detect diffuse gamma-ray emission from the Perseus galaxy cluster. We perform a detailed spatial and spectral modelling of the expected signal for the DM and the CRp components. For each, we compute the expected CTA sensitivity. The observing strategy of Perseus is also discussed. In the absence of a diffuse signal (non-detection), CTA should constrain the CRp to thermal energy ratio within the radius $R_{500}$ down to about X_{500}<3\times 10^{-3}, for a spatial CRp distribution that follows the thermal gas and a CRp spectral index $α_{\rm CRp}=2.3$. Under the optimistic assumption of a pure hadronic origin of the Perseus radio mini-halo and depending on the assumed magnetic field profile, CTA should measure $α_{\rm CRp}$ down to about $Δα_{\rm CRp}\simeq 0.1$ and the CRp spatial distribution with 10% precision. Regarding DM, CTA should improve the current ground-based gamma-ray DM limits from clusters observations on the velocity-averaged annihilation cross-section by a factor of up to $\sim 5$, depending on the modelling of DM halo substructure. In the case of decay of DM particles, CTA will explore a new region of the parameter space, reaching models with τ_χ>10^{27}s for DM masses above 1 TeV. These constraints will provide unprecedented sensitivity to the physics of both CRp acceleration and transport at cluster scale and to TeV DM particle models, especially in the decay scenario

Dark matter line searches with the Cherenkov Telescope Array

Monochromatic gamma-ray signals constitute a potential smoking gun signature for annihilating or decaying dark matter particles that could relatively easily be distinguished from astrophysical or instrumental backgrounds. We provide an updated assessment of the sensitivity of the Cherenkov Telescope Array (CTA) to such signals, based on observations of the Galactic centre region as well as of selected dwarf spheroidal galaxies. We find that current limits and detection prospects for dark matter masses above 300 GeV will be significantly improved, by up to an order of magnitude in the multi-TeV range. This demonstrates that CTA will set a new standard for gamma-ray astronomy also in this respect, as the world's largest and most sensitive high-energy gamma-ray observatory, in particular due to its exquisite energy resolution at TeV energies and the adopted observational strategy focussing on regions with large dark matter densities. Throughout our analysis, we use up-to-date instrument response functions, and we thoroughly model the effect of instrumental systematic uncertainties in our statistical treatment. We further present results for other potential signatures with sharp spectral features, e.g. box-shaped spectra, that would likewise very clearly point to a particle dark matter origin

Southern African Large Telescope Spectroscopy of BL Lacs for the CTA project

In the last two decades, very-high-energy gamma-ray astronomy has reached maturity: over 200 sources have been detected, both Galactic and extragalactic, by ground-based experiments. At present, Active Galactic Nuclei (AGN) make up about 40% of the more than 200 sources detected at very high energies with ground-based telescopes, the majority of which are blazars, i.e. their jets are closely aligned with the line of sight to Earth and three quarters of which are classified as high-frequency peaked BL Lac objects. One challenge to studies of the cosmological evolution of BL Lacs is the difficulty of obtaining redshifts from their nearly featureless, continuum-dominated spectra. It is expected that a significant fraction of the AGN to be detected with the future Cherenkov Telescope Array (CTA) observatory will have no spectroscopic redshifts, compromising the reliability of BL Lac population studies, particularly of their cosmic evolution. We started an effort in 2019 to measure the redshifts of a large fraction of the AGN that are likely to be detected with CTA, using the Southern African Large Telescope (SALT). In this contribution, we present two results from an on-going SALT program focused on the determination of BL Lac object redshifts that will be relevant for the CTA observatory

Southern African Large Telescope Spectroscopy of BL Lacs for the CTA project

In the last two decades, very-high-energy gamma-ray astronomy has reached maturity: over 200 sources have been detected, both Galactic and extragalactic, by ground-based experiments. At present, Active Galactic Nuclei (AGN) make up about 40% of the more than 200 sources detected at very high energies with ground-based telescopes, the majority of which are blazars, i.e. their jets are closely aligned with the line of sight to Earth and three quarters of which are classified as high-frequency peaked BL Lac objects. One challenge to studies of the cosmological evolution of BL Lacs is the difficulty of obtaining redshifts from their nearly featureless, continuum-dominated spectra. It is expected that a significant fraction of the AGN to be detected with the future Cherenkov Telescope Array (CTA) observatory will have no spectroscopic redshifts, compromising the reliability of BL Lac population studies, particularly of their cosmic evolution. We started an effort in 2019 to measure the redshifts of a large fraction of the AGN that are likely to be detected with CTA, using the Southern African Large Telescope (SALT). In this contribution, we present two results from an on-going SALT program focused on the determination of BL Lac object redshifts that will be relevant for the CTA observatory