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This is a repository copy of Effectiveness of a national quality improvement programme to improve survival after emergency abdominal surgery (EPOCH) : a stepped-wedge cluster-randomised trial. Effectiveness of a national quality improvement programme to improve survival after emergency abdominal surgery (EPOCH) : a stepped-wedge cluster-randomised trial. The Lancet. ISSN 0140-6736 https://doi.org/10.1016/S0140-6736(18)32521-2 eprints@whiterose.ac.uk https://eprints.whiterose.ac.uk/ ReuseThis article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs (CC BY-NC-ND) licence. This licence only allows you to download this work and share it with others as long as you credit the authors, but you can't change the article in any way or use it commercially. More information and the full terms of the licence here: https://creativecommons.org/licenses/ Implications of all the available evidenceDespite the success of some smaller projects, there was no survival benefit from a national quality improvement programme to implement a care pathway for patients undergoing emergency abdominal surgery. To succeed, large national quality improvement programmes need to allow for differences between hospitals and ensure teams have both the time and resources needed to improve patient care.

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A small blackish muntjac has been discovered in the west Quang Nam province of Vietnam. DNA sequencing of six individuals showed that this is a distinct species. A description is given. The new find is the third new ungulate species to be discovered in Vietnam in five years. The paper predicts that more species remain to be found in the Annamite mountain range and includes DNA analysis from two more undescribed species. The DNA analysis indicates that there has been a radiation of several related muntjac species in the Annamite mountains, also that the new truongson muntjac shows high intraspecific genetic diversity indicative of a large effective population size. The paper discusses the significance of these finds from an evolutionary and conservation viewpoint. The authors urge conservation authorities in the IndoChinese countries to devote special measures to protect this site of dynamic evolution which retains a combination of relict endemics (e.g. Pseudoryx) as well as on‐going speciation.