Global Impact of COVID-19 on Stroke Care and IV Thrombolysis

OBJECTIVE: To measure the global impact of COVID-19 pandemic on volumes of IV thrombolysis (IVT), IVT transfers, and stroke hospitalizations over 4 months at the height of the pandemic (March 1 to June 30, 2020) compared with 2 control 4-month periods. METHODS: We conducted a cross-sectional, observational, retrospective study across 6 continents, 70 countries, and 457 stroke centers. Diagnoses were identified by their ICD-10 codes or classifications in stroke databases. RESULTS: There were 91,373 stroke admissions in the 4 months immediately before compared to 80,894 admissions during the pandemic months, representing an 11.5% (95% confidence interval [CI] -11.7 to -11.3, p < 0.0001) decline. There were 13,334 IVT therapies in the 4 months preceding compared to 11,570 procedures during the pandemic, representing a 13.2% (95% CI -13.8 to -12.7, p < 0.0001) drop. Interfacility IVT transfers decreased from 1,337 to 1,178, or an 11.9% decrease (95% CI -13.7 to -10.3, p = 0.001). Recovery of stroke hospitalization volume (9.5%, 95% CI 9.2-9.8, p < 0.0001) was noted over the 2 later (May, June) vs the 2 earlier (March, April) pandemic months. There was a 1.48% stroke rate across 119,967 COVID-19 hospitalizations. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was noted in 3.3% (1,722/52,026) of all stroke admissions. CONCLUSIONS: The COVID-19 pandemic was associated with a global decline in the volume of stroke hospitalizations, IVT, and interfacility IVT transfers. Primary stroke centers and centers with higher COVID-19 inpatient volumes experienced steeper declines. Recovery of stroke hospitalization was noted in the later pandemic months. © 2021 American Academy of Neurology

Measurement of the (Formula presented.) and tH production rates in the (Formula presented.) decay channel using proton-proton collision data at (Formula presented.) TeV

An analysis of the production of a Higgs boson (H) in association with a top quark-antiquark pair (tt¯H) or a single top quark (tH) is presented. The Higgs boson decay into a bottom quark-antiquark pair (H → bb¯) is targeted, and three different final states of the top quark decays are considered, defined by the number of leptons (electrons or muons) in the event. The analysis utilises proton-proton collision data collected at the CERN LHC with the CMS experiment at s = 13 TeV in 2016–2018, which correspond to an integrated luminosity of 138 fb−1. The observed tt¯H production rate relative to the standard model expectation is 0.33 ± 0.26 = 0.33 ± 0.17(stat) ± 0.21(syst). Additionally, the tt¯H production rate is determined in intervals of Higgs boson transverse momentum. An upper limit at 95% confidence level is set on the tH production rate of 14.6 times the standard model prediction, with an expectation of 19.3−6.0+9.2. Finally, constraints are derived on the strength and structure of the coupling between the Higgs boson and the top quark from simultaneous extraction of the tt¯H and tH production rates, and the results are combined with those obtained in other Higgs boson decay channels

Measurement of the inclusive tt¯ cross section in final states with at least one lepton and additional jets with 302 pb−1 of pp collisions at s = 5.02 TeV

A measurement of the top quark pair (tt¯) production cross section in proton-proton collisions at a centre-of-mass energy of 5.02 TeV is presented. The data were collected at the LHC in autumn 2017, in dedicated runs with low-energy and low-intensity conditions with respect to the default configuration, and correspond to an integrated luminosity of 302 pb−1. The measurement is performed using events with one electron or muon, and multiple jets, at least one of them being identified as originating from a b quark (b tagged). Events are classified based on the number of all reconstructed jets and of b-tagged jets. Multivariate analysis techniques are used to enhance the separation between the signal and backgrounds. The measured cross section is 62.5±1.6stat−2.5+2.6syst±1.2lumi pb. A combination with the result in the dilepton channel based on the same data set yields a value of 62.3 ± 1.5 (stat) ± 2.4 (syst) ± 1.2 (lumi) pb, to be compared with the standard model prediction of 69.5−3.7+3.5 pb at next-to-next-to-leading order in perturbative quantum chromodynamics

The ASOS Surgical Risk Calculator: development and validation of a tool for identifying African surgical patients at risk of severe postoperative complications

Background: The African Surgical Outcomes Study (ASOS) showed that surgical patients in Africa have a mortality twice the global average. Existing risk assessment tools are not valid for use in this population because the pattern of risk for poor outcomes differs from high-income countries. The objective of this study was to derive and validate a simple, preoperative risk stratification tool to identify African surgical patients at risk for in-hospital postoperative mortality and severe complications. Methods: ASOS was a 7-day prospective cohort study of adult patients undergoing surgery in Africa. The ASOS Surgical Risk Calculator was constructed with a multivariable logistic regression model for the outcome of in-hospital mortality and severe postoperative complications. The following preoperative risk factors were entered into the model; age, sex, smoking status, ASA physical status, preoperative chronic comorbid conditions, indication for surgery, urgency, severity, and type of surgery. Results: The model was derived from 8799 patients from 168 African hospitals. The composite outcome of severe postoperative complications and death occurred in 423/8799 (4.8%) patients. The ASOS Surgical Risk Calculator includes the following risk factors: age, ASA physical status, indication for surgery, urgency, severity, and type of surgery. The model showed good discrimination with an area under the receiver operating characteristic curve of 0.805 and good calibration with c-statistic corrected for optimism of 0.784. Conclusions: This simple preoperative risk calculator could be used to identify high-risk surgical patients in African hospitals and facilitate increased postoperative surveillance. © 2018 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.Medical Research Council of South Africa gran

Search for rare decays of the Z and Higgs bosons to a J/ψ or ψ(2S) meson and a photon in proton-proton collisions at s=13TeV

A search is presented for rare decays of the Image 1 and Higgs bosons to a photon and a Image 2 or a Image 3 meson, with the charmonium state subsequentially decaying to a pair of muons. The data set corresponds to an integrated luminosity of 123fb−1 of proton-proton collisions at a center-of-mass energy of 13 TeV collected with the CMS detector at the LHC. No evidence for branching fractions of these rare decay channels larger than predicted in the standard model is observed. Upper limits at 95% confidence level are set: Image 4, Image 5, Image 6, and Image 7. The ratio of the Higgs boson coupling modifiers Image 8 is constrained to be in the interval (−157,+199) at 95% confidence level. Assuming Image 9, this interval becomes (−166,+208)

Observation of nuclear modification of energy-energy correlators inside jets in heavy ion collisions

Energy-energy correlators are constructed by averaging the number of charged particle pairs within jets, weighted by the product of their transverse momenta, as a function of the angular separation of the particles within a pair. They are sensitive to a multitude of perturbative and nonperturbative quantum chromodynamics phenomena in high-energy particle collisions. Using lead-lead data recorded with the CMS detector, energy-energy correlators inside high transverse momentum jets are measured in heavy ion collisions for the first time. The data are obtained at a nucleon-nucleon center-of-mass energy of 5.02 TeV and correspond to an integrated luminosity of 1.70nb−1. A similar analysis is done for proton-proton collisions at the same center-of-mass energy to establish a reference. The ratio of lead-lead to proton-proton energy-energy correlators reveals significant jet substructure modifications in the quark-gluon plasma. The results are compared to different models that incorporate either color coherence or medium response effects, where the two effects predict similar substructure modifications

Identification of low-momentum muons in the CMS detector using multivariate techniques in proton-proton collisions at √s = 13.6 TeV

"Soft"muons with a transverse momentum below 10 GeV are featured in many processes studied by the CMS experiment, such as decays of heavy-flavor hadrons or rare tau lepton decays. Maximizing the selection efficiency for these muons, while simultaneously suppressing backgrounds from long-lived light-flavor hadron decays, is therefore important for the success of the CMS physics program. Multivariate techniques have been shown to deliver better muon identification performance than traditional selection techniques. To take full advantage of the large data set currently being collected during Run 3 of the CERN LHC, a new multivariate classifier based on a gradient-boosted decision tree has been developed. It offers a significantly improved separation of signal and background muons compared to a similar classifier used for the analysis of the Run 2 data. The performance of the new classifier is evaluated on a data set collected with the CMS detector in 2022 and 2023, corresponding to an integrated luminosity of 62 fb-