The constant threat of terrorism: stress levels and coping strategies amongst university students of Karachi

OBJECTIVES: To assess the levels of stress in the face of terrorism and the adopted coping strategies, amongst the student population of universities in Karachi . METHODS: A descriptive, cross sectional study was conducted on undergraduate students from four universities of Karachi. Self-administered questionnaires were filled out by 291 students. Pearson Chi-Square test was used to assess associations between stress levels and different variables at a level of significance of 0.05% . RESULTS: A total of 65.8% of the students had mild stress levels, 91.5% of university students were exposed to terrorism through television, while only 26.5% students reported personal exposure to terrorism. 67.4% students were forbidden by their parents to go out (p = 0.002). Most of those who had self exposure to an attack were the ones whose parents forbade them from going out (p = 0.00). Most commonly used coping strategy was increased faith in religion. Irritability was the most common stress symptom . CONCLUSION: A majority of students studying in universities of Karachi had mild stress levels due to the constant threat of terrorism whereas a minority had severe stress levels. Possible reasons for resilience and only mild stress levels could be the history of Karachi\u27s internal conflicts and its prolonged duration of being exposed to terrorism. These students who are positive for stress need to be targeted for counseling either through the media or through their universities. More extensive research is needed in this area

Physicians Preferences of Virtual Versus In-Person Visits in Neuromuscular Clinical Practice: Telemedicine preference of neuromuscular practitioners

Background: While the role of telemedicine is well established in certain fields of medicine, its role in disciplines like Neuromuscular medicine is not clear. COVID 19 pandemic compelled the medical community to utilize telemedicine and policies were rapidly changed to continue patient care during the pandemic. However, to guide the future of telemedicine in this field where a physical exam is an integral part of the visit, it is imperative to get a physician's opinion on this matter. We designed this study to assess the opinion of neuromuscular physicians about telemedicine, their preference, and factors influencing their decision. Methods: We used an online form composed of eleven questions to survey 94 neuromuscular specialists across the USA and Canada during September 2020. Results:  90.43% of participating neuromuscular specialists preferred physical visits with new patients versus 44.68% preferred physical visits with follow-up patients. The majority thought that telemedicine reduces revenue (58.51%), quality of service (57.45%), and quality time spent with patients (62.77%). Nevertheless, most surveyed physicians agreed that telemedicine is time-efficient (84.04%), improves patient compliance (70.21%), and will be a long-term solution in clinical practice (67.02%). Finally, 58.51% revealed that telemedicine does not affect workload. Conclusion: Neuromuscular specialists preferred seeing new patients and revealing a new diagnosis to the patient in physical visits, but they also considered telemedicine a long-term method that would continue to increase in the post-pandemic future, emphasizing the need to address their concerns to facilitate telemedicine.  &nbsp

Verbal Autopsy of Maternal Mortality in Rawalpindi District

Objective: To identify the causes and risk factors leading to maternal mortality through verbal autopsy in the District of Rawalpindi, Pakistan. Study Design: A retrospective, descriptive study. Place and Duration of Study: The study was carried out in Community Department of Foundation University Medical College Islamabad from January 05, 2019, to December 25, 2019. Materials and Methods: Data of 105 women died of causes related to death during pregnancy/ delivery between 01 April 2013 and 30 April 2018 was retrieved from the office of District Health Officer (DHO) Rawalpindi. A Verbal Autopsy was conducted to determine cause of death and the possible risk factors, through a structured questionnaire that was filled by close relatives of the deceased women. Analysis of data was done using SPSS version 25.0. Results: The Mean age of the patients was 31 years, and it ranged from 15 to 49 years. In 26.7% of mothers cause of death could not be determined. Overall, the major and most obvious cause of maternal death was delivery related hemorrhage in 58% cases. Out of these, antepartum hemorrhage was the commonest cause occurring in 43.8% of the total cases. Postpartum hemorrhage occurred in 11.4% cases, while fatal hemorrhage during the delivery occurred in 2.8% mothers. Eclampsia was the next common cause that occurred in 11.4% mothers. Difficult and prolonged labour was found to be cause of death in 2.8% cases, while 0.95% died of Sepsis. Among the risk factors, lack of antenatal care emerged as the leading risk factor, present in 62% mothers, followed by anemia being present in 46.6% mothers. Multi-parity was found to be the next common risk factor being present in 26.6% mothers. Reduced interval in successive pregnancies was found in 21% cases. Systemic medical disorders like hypertension, renal disorders, Diabetes Mellitus, Pneumonia, hepatic failure, were found in 6.66% mothers. History of complications in previous pregnancies was present in 3.8% cases. History of lack of proper medical services in the hospital as possible factor leading to death was present in only 5 (4.8%) cases. Conclusion: Hemorrhage related with delivery, especially the antepartum hemorrhage emerged as the commonest cause of maternal mortality, followed by eclampsia. At the same time, lack of antenatal care and anaemia emerged as the commonest risk factors in this regard

Patient preference for virtual versus in-person visits in neuromuscular clinical practice.

Introduction/aimsIt is unknown if patients with neuromuscular diseases prefer in-person or virtual telemedicine visits. We studied patient opinions and preference on virtual versus in-person visits, and the factors influencing such preferences.MethodsTelephone surveys, consisting of 11 questions, of patients from 10 neuromuscular centers were completed.ResultsFive hundred and twenty surveys were completed. Twenty-six percent of respondents preferred virtual visits, while 50% preferred in-person visits. Sixty-four percent reported physical interaction as "very important." For receiving a new diagnosis, 55% preferred in-person vs 35% reporting no preference. Forty percent were concerned about a lack of physical examination vs 20% who were concerned about evaluating vital signs. Eighty four percent reported virtual visits were sufficiently private. Sixty eight percent did not consider expenses a factor in their preference. Although 92% were comfortable with virtual communication technology, 55% preferred video communications, and 19% preferred phone calls. Visit preference was not significantly associated with gender, diagnosis, disease severity, or symptom management. Patients who were concerned about a lack of physical exam or assessment of vitals had significantly higher odds of selecting in-person visits than no preference.DiscussionAlthough neither technology, privacy, nor finance burdened patients in our study, more patients preferred in-person visits than virtual visits and 40% were concerned about a lack of physical examination. Interactions that occur with in-person encounters had high importance for patients, reflecting differences in the perception of the patient-physician relationship between virtual and in-person visits

Search for CPCP violation in D0^0→\to KS0^0_\mathrm{S}KS0^0_\mathrm{S} decays in proton-proton collisions at s\sqrt{s} = 13 TeV

International audienceA search is reported for charge-parity D$^0$$\to$ K$^0_\mathrm{S}$K$^0_\mathrm{S}$$CP$ violation in D$^0$$\to$ K$^0_\mathrm{S}$K$^0_\mathrm{S}$ decays, using data collected in proton-proton collisions at $\sqrt{s}$ = 13 TeV recorded by the CMS experiment in 2018. The analysis uses a dedicated data set that corresponds to an integrated luminosity of 41.6 fb$^{-1}$, which consists of about 10 billion events containing a pair of ẖadrons, nearly all of which decay to charm hadrons. The flavor of the neutral D meson is determined by the pion charge in the reconstructed decays D$^{*+}$$\to$ D$^0\pi^+$ and D$^{*-}$$\to$ D$^0\pi^-$. The D$^0$$\to$ K$^0_\mathrm{S}$K$^0_\mathrm{S}$$CP$ asymmetry in D$^0$$\to$ K$^0_\mathrm{S}$K$^0_\mathrm{S}$ is measured to be $A_{CP}$( K$^0_\mathrm{S}$K$^0_\mathrm{S}$) = (6.2 $\pm$ 3.0 $\pm$ 0.2 $\pm$ 0.8)%, where the three uncertainties represent the statistical uncertainty, the systematic uncertainty, and the uncertainty in the measurement of the D$^0$ $\to$ K$^0_\mathrm{S}$K$^0_\mathrm{S}$ $CP$ asymmetry in the D$^0$ $\to$ K$^0_\mathrm{S}\pi^+\pi^-$ decay. This is the first D$^0$ $\to$ K$^0_\mathrm{S}$K$^0_\mathrm{S}$ $CP$ asymmetry measurement by CMS in the charm sector as well as the first to utilize a fully hadronic final state

Observation of the J/ψ\psi →\to μ+μ−μ+μ−\mu^+\mu^-\mu^+\mu^- decay in proton-proton collisions at s\sqrt{s} = 13 TeV

International audienceThe J/$\psi$$\to$$\mu^+\mu^-\mu^+\mu^-$ decay has been observed with a statistical significance in excess of five standard deviations. The analysis is based on an event sample of proton-proton collisions at a center-of-mass energy of 13 TeV, collected by the CMS experiment in 2018 and corresponding to an integrated luminosity of 33.6 fb${-1}$. Normalizing to the J/$\psi$$\to$$\mu^+\mu^-$ decay mode leads to a branching fraction [10.1$^{+3.3}_{-2.7}$ (stat) $\pm$ 0.4 (syst) ]$\times$ 10$^{-7}$, a value that is consistent with the standard model prediction

Enriching the physics program of the CMS experiment via data scouting and data parking

International audienceSpecialized data-taking and data-processing techniques were introduced by the CMS experiment in Run 1 of the CERN LHC to enhance the sensitivity of searches for new physics and the precision of standard model measurements. These techniques, termed data scouting and data parking, extend the data-taking capabilities of CMS beyond the original design specifications. The novel data-scouting strategy trades complete event information for higher event rates, while keeping the data bandwidth within limits. Data parking involves storing a large amount of raw detector data collected by algorithms with low trigger thresholds to be processed when sufficient computational power is available to handle such data. The research program of the CMS Collaboration is greatly expanded with these techniques. The implementation, performance, and physics results obtained with data scouting and data parking in CMS over the last decade are discussed in this Report, along with new developments aimed at further improving low-mass physics sensitivity over the next years of data taking

Observation of the J/ψ\psi→\toμ+μ−μ+μ−\mu^+\mu^-\mu^+\mu^- decay in proton-proton collisions at s\sqrt{s} = 13 TeV

International audienceThe J/$\psi$$\to$$\mu^+\mu^-\mu^+\mu^-$ decay has been observed with a statistical significance in excess of five standard deviations. The analysis is based on an event sample of proton-proton collisions at a center-of-mass energy of 13 TeV, collected by the CMS experiment in 2018 and corresponding to an integrated luminosity of 33.6 fb${-1}$. Normalizing to the J/$\psi$$\to$$\mu^+\mu^-$ decay mode leads to a branching fraction [10.1$^{+3.3}_{-2.7}$ (stat) $\pm$ 0.4 (syst) ]$\times$ 10$^{-7}$, a value that is consistent with the standard model prediction

The CMS Statistical Analysis and Combination Tool: COMBINE

International audienceThis paper describes the COMBINE software package used for statistical analyses by the CMS Collaboration. The package, originally designed to perform searches for a Higgs boson and the combined analysis of those searches, has evolved to become the statistical analysis tool presently used in the majority of measurements and searches performed by the CMS Collaboration. It is not specific to the CMS experiment, and this paper is intended to serve as a reference for users outside of the CMS Collaboration, providing an outline of the most salient features and capabilities. Readers are provided with the possibility to run COMBINE and reproduce examples provided in this paper using a publicly available container image. Since the package is constantly evolving to meet the demands of ever-increasing data sets and analysis sophistication, this paper cannot cover all details of COMBINE. However, the online documentation referenced within this paper provides an up-to-date and complete user guide