BackgroundTo validate a new practical Sepsis Severity Score for patients with complicated intra-abdominal infections (cIAIs) including the clinical conditions at the admission (severe sepsis/septic shock), the origin of the cIAIs, the delay in source control, the setting of acquisition and any risk factors such as age and immunosuppression.MethodsThe WISS study (WSES cIAIs Score Study) is a multicenter observational study underwent in 132 medical institutions worldwide during a four-month study period (October 2014-February 2015). Four thousand five hundred thirty-three patients with a mean age of 51.2 years (range 18–99) were enrolled in the WISS study.ResultsUnivariate analysis has shown that all factors that were previously included in the WSES Sepsis Severity Score were highly statistically significant between those who died and those who survived (p < 0.0001). The multivariate logistic regression model was highly significant (p < 0.0001, R2 = 0.54) and showed that all these factors were independent in predicting mortality of sepsis. Receiver Operator Curve has shown that the WSES Severity Sepsis Score had an excellent prediction for mortality. A score above 5.5 was the best predictor of mortality having a sensitivity of 89.2 %, a specificity of 83.5 % and a positive likelihood ratio of 5.4.ConclusionsWSES Sepsis Severity Score for patients with complicated Intra-abdominal infections can be used on global level. It has shown high sensitivity, specificity, and likelihood ratio that may help us in making clinical decisions.

HAL is a multi-disciplinary open access archive for the deposit and dissemination of scientific research documents, whether they are published or not. The documents may come from teaching and research institutions in France or abroad, or from public or private research centers. AbstractThe efficiency of unilateral climate policies may be hampered by carbon leakage and competitiveness losses. A widely discussed policy option to reduce leakage and protect competitiveness of heavy industries is to impose border carbon adjustments (BCAs). The estimation of carbon leakage as well as the assessment of different policy options led to a substantial body of literature in energyeconomic modeling.In order to give a quantitative overview on the most recent research of the topic, we conduct a meta-analysis on 25 studies, altogether providing 310 estimates of carbon leakage ratio according to different assumptions and models. The typical range of carbon leakage estimates are from 5% to 25% (mean 14%) without policy and from -5% to 15% (mean 6%) with BCAs.A meta-regression analysis is performed to further investigate the impact of different assumptions on the leakage estimates. The decrease of the leakage ratio with the size of the coalition is confirmed and quantified. Among the BCAs options, the extension of BCAs to all sectors and the inclusion of export rebates are the most efficient features in the meta-regression model to reduce the leakage ratio. All other parameters being constant, BCAs reduce leakage ratio by 6 percentage points.

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International audienceIn a world with uneven climate policies, the carbon price differentials across regions could shift the production of energy-intensive goods from carbon-constrained countries to " carbon havens " , or countries with laxer climate policy. This would reduce the environmental benefits of the policy (carbon leakage) while potentially damaging the economy (competitiveness concerns). A review on these questions is provided in this article. First we discuss the main terms involved such as carbon leakage, competitiveness, sectors at risk or climate spillovers. Then we analyse the studies evaluating the carbon leakage risk. Most ex ante modelling studies conclude to leakage rates in the range of 5-20% (if no option to mitigate leakage is implemented) whereas ex post econometric studies haven't revealed statistically significant evidence of leakage. Different policy options to face these issues are then examined with an emphasis on Border Carbon Adjustments (BCA). BCA consist in reducing the carbon price differentials of goods traded between countries. Properly implemented, they can reduce leakage (by around 10 percentage points in ex ante modelling studies) in a cost-effective way but are controversial because they shift a part of the abatement costs from abating countries to non-abating countries. Their impact on international negotiations is unclear: they could encourage third countries to join the abating coalition or trigger a trade war. Besides, their consistency with WTO rules is highly contentious among legal experts