Prospective validation of the CLIP score: a new prognostic system for patient with cirrhosis and hepatocellular carcinoma

Prognosis of patients with cirrhosis and hepatocellular carcinoma (HCC) depends on both residual liver function and tumor extension. The CLIP score includes Child-Pugh stage, tumor morphology and extension, serum alfa-fetoprotein (AFP) levels, and portal vein thrombosis. We externally validated the CLIP score and compared its discriminatory ability and predictive power with that of the Okuda staging system in 196 patients with cirrhosis and HCC prospectively enrolled in a randomized trial. No significant associations were found between the CLIP score and the age, sex, and pattern of viral infection. There was a strong correlation between the CLIP score and the Okuda stage, As of June 1999, 150 patients (76.5%) had died. Median survival time was 11 months, overall, and it was 36, 22, 9, 7, and 3 months for CLIP categories 0, 1, 2, 3, and 4 to 6, respectively. In multivariate analysis, the CLIP score had additional explanatory power above that of the Okuda stage. This was true for both patients treated with locoregional therapy or not. A quantitative estimation of 2-year survival predictive power showed that the CLIP score explained 37% of survival variability, compared with 21% explained by Okuda stage. In conclusion, the CLIP score, compared with the Okuda staging system, gives more accurate prognostic information, is statistically more efficient, and has a greater survival predictive power. It could be useful in treatment planning by improving baseline prognostic evaluation of patients with RCC, and could be used in prospective therapeutic trials as a stratification variable, reducing the variability of results owing to patient selection

Appropriateness of antiplatelet therapy for primary and secondary cardio- and cerebrovascular prevention in acutely hospitalized older people

Aims: Antiplatelet therapy is recommended for the secondary prevention of cardio- and cerebrovascular disease, but for primary prevention it is advised only in patients at very high risk. With this background, this study aims to assess the appropriateness of antiplatelet therapy in acutely hospitalized older people according to their risk profile. Methods: Data were obtained from the REPOSI register held in Italian and Spanish internal medicine and geriatric wards in 2012 and 2014. Hospitalized patients aged 6565 assessable at discharge were selected. Appropriateness of the antiplatelet therapy was evaluated according to their primary or secondary cardiovascular prevention profiles. Results: Of 2535 enrolled patients, 2199 were assessable at discharge. Overall 959 (43.6%, 95% CI 41.5\u201345.7) were prescribed an antiplatelet drug, aspirin being the most frequently chosen. Among patients prescribed for primary prevention, just over half were inappropriately prescribed (52.1%), being mainly overprescribed (155/209 patients, 74.2%). On the other hand, there was also a high rate of inappropriate underprescription in the context of secondary prevention (222/726 patients, 30.6%, 95% CI 27.3\u201334.0%). Conclusions: This study carried out in acutely hospitalized older people shows a high degree of inappropriate prescription among patients prescribed with antiplatelets for primary prevention, mainly due to overprescription. Further, a large proportion of patients who had had overt cardio- or cerebrovascular disease were underprescribed, in spite of the established benefits of antiplatelet drugs in the context of secondary prevention

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

Search for supersymmetry in pp collisions at in events with a single lepton, large jet multiplicity, and multiple b jets

Results are reported from a search for supersymmetry in pp collisions at a center-of-mass energy of 8 TeV, based on events with a single isolated lepton (electron or muon) and multiple jets, at least two of which are identified as b jets. The data sample corresponds to an integrated luminosity of 19.3 fb(-1) recorded by the CMS experiment at the LHC in 2012. The search is motivated by supersymmetric models that involve strong-production processes and cascade decays of new particles. The resulting final states contain multiple jets as well as missing transverse momentum from weakly interacting particles. The event yields, observed across several kinematic regions, are consistent with the expectations from standard model processes. The results are interpreted in the context of simplified supersymmetric scenarios with pair production of gluinos, where each gluino decays to a top quark-antiquark pair and the lightest neutralino. For the case of decays via virtual top squarks, gluinos with a mass smaller than 1.26 TeV are excluded for low neutralino masses

Search for excited quarks in the gamma plus jet final state in proton-proton collisions at root s=8 TeV

A search for excited quarks decaying into the gamma + jet final state is presented. The analysis is based on data corresponding to an integrated luminosity of 19.7 fb(-1) collected by the CMS experiment in proton-proton collisions at root s = 8 TeV at the LHC. Events with photons and jets with high transverse momenta are selected and the gamma + jet invariant mass distribution is studied to search for a resonance peak. The 95% confidence level upper limits on the product of cross section and branching fraction are evaluated as a function of the excited quark mass. Limits on excited quarks are presented as a function of their mass and coupling strength; masses below 3.5 TeV are excluded at 95% confidence level for unit couplings to their standard model partners

Measurement of the ratio B(t -> Wb)/B(t -> Wq) in pp collisions at root s=8 TeV

The ratio of the top-quark branching fractions R = B(t --> Wb)/B(t --> Wq), where the denominator includes the sum over all down-type quarks (q = b, s, d), is measured in the t (t) over bar dilepton final state with proton-proton collision data at root s = 8 TeV from an integrated luminosity of 19.7 fb(-1), collected with the CMS detector. In order to quantify the purity of the signal sample, the cross section is measured by fitting the observed jet multiplicity, thereby constraining the signal and background contributions. By counting the number of b jets per event, an unconstrained value of R = 1.014 +/- 0.003 (stat.) +/- 0.032 (syst.) is measured, in a good agreement with current precision measurements in electroweak and flavour sectors. A lower limit R > 0.955 at the 95% confidence level is obtained after requiring R 0.975 is set at 95% confidence level. The result is combined with a previous CMS measurement of the t-channel single-top-quark cross section to determine the top-quark total decay width, Gamma(t) = 1.36 +/- 0.02 (stat.)(-0.11)(+0.14) (syst.) GeV

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)

Search for pair production of third-generation scalar leptoquarks and top squarks in proton-proton collisions at v root s=8 TeV

A search for pair production of third-generation scalar leptoquarks and supersymmetric top quark partners, top squarks, in final states involving tau leptons and bottom quarks is presented. The search uses events from a data sample of proton-proton collisions corresponding to an integrated luminosity of 19.7 fb(-1), collected with the CMS detector at the LHC with root s = 8 TeV. The number of observed events is found to be in agreement with the expected standard model background. Third-generation scalar leptoquarks with masses below 740 GeV are excluded at 95% confidence level, assuming a 100% branching fraction for the leptoquark decay to a tau lepton and a bottom quark. In addition, this mass limit applies directly to top squarks decaying via an R-parity violating coupling. lambda(') (333). The search also considers a similar signature from top squarks undergoing a chargino-mediated decay involving the Rparity violating coupling. lambda(')(3jk). Each top squark decays to a tau lepton, a bottom quark, and two light quarks. Top squarks in this model with masses below 580 GeV are excluded at 95% confidence level. The constraint on the leptoquark mass is the most stringent to date, and this is the first search for top squarks decaying via. lambda(')(3jk)

Performance of the CMS missing transverse momentum reconstruction in pp data at √s= 8 TeV

The performance of missing transverse energy reconstruction algorithms is presented using root s = 8 TeV proton-proton (pp) data collected with the CMS detector. Events with anomalous missing transverse energy are studied, and the performance of algorithms used to identify and remove these events is presented. The scale and resolution for missing transverse energy, including the effects of multiple pp interactions (pileup), are measured using events with an identified Z boson or isolated photon, and are found to be well described by the simulation. Novel missing transverse energy reconstruction algorithms developed specifically to mitigate the effects of large numbers of pileup interactions on the missing transverse energy resolution are presented. These algorithms significantly reduce the dependence of the missing transverse energy resolution on pileup interactions. Finally, an algorithm that provides an estimate of the significance of the missing transverse energy is presented, which is used to estimate the compatibility of the reconstructed missing transverse energy with a zero nominal value

Constraints on the Higgs boson width from off-shell production and decay to Z-boson pairs

Constraints are presented on the total width of the recently discovered Higgs boson, Gamma(H), using its relative on-shell and off-shell production and decay rates to a pair of Z bosons, where one Z boson decays to an electron or muon pair, and the other to an electron, muon, or neutrino pair. The analysis is based on the data collected by the CMS experiment at the LHC in 2011 and 2012, corresponding to integrated luminosities of 5.1 fb(-1) at a center-of-mass energy root s = 7 TeV and 19.7 fb(-1) at root s = 8 TeV. A simultaneous maximum likelihood fit to the measured kinematic distributions near the resonance peak and above the Z-boson pair production threshold leads to an upper limit on the Higgs boson width of Gamma(H) < 22 MeV at a 95% confidence level, which is 5.4 times the expected value in the standard model at the measured mass of m(H) = 125.6 GeV