Immunocompromised patients with acute respiratory distress syndrome : Secondary analysis of the LUNG SAFE database

The aim of this study was to describe data on epidemiology, ventilatory management, and outcome of acute respiratory distress syndrome (ARDS) in immunocompromised patients. Methods: We performed a post hoc analysis on the cohort of immunocompromised patients enrolled in the Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure (LUNG SAFE) study. The LUNG SAFE study was an international, prospective study including hypoxemic patients in 459 ICUs from 50 countries across 5 continents. Results: Of 2813 patients with ARDS, 584 (20.8%) were immunocompromised, 38.9% of whom had an unspecified cause. Pneumonia, nonpulmonary sepsis, and noncardiogenic shock were their most common risk factors for ARDS. Hospital mortality was higher in immunocompromised than in immunocompetent patients (52.4% vs 36.2%; p < 0.0001), despite similar severity of ARDS. Decisions regarding limiting life-sustaining measures were significantly more frequent in immunocompromised patients (27.1% vs 18.6%; p < 0.0001). Use of noninvasive ventilation (NIV) as first-line treatment was higher in immunocompromised patients (20.9% vs 15.9%; p = 0.0048), and immunodeficiency remained independently associated with the use of NIV after adjustment for confounders. Forty-eight percent of the patients treated with NIV were intubated, and their mortality was not different from that of the patients invasively ventilated ab initio. Conclusions: Immunosuppression is frequent in patients with ARDS, and infections are the main risk factors for ARDS in these immunocompromised patients. Their management differs from that of immunocompetent patients, particularly the greater use of NIV as first-line ventilation strategy. Compared with immunocompetent subjects, they have higher mortality regardless of ARDS severity as well as a higher frequency of limitation of life-sustaining measures. Nonetheless, nearly half of these patients survive to hospital discharge. Trial registration: ClinicalTrials.gov, NCT02010073. Registered on 12 December 2013

Mechanical ventilation in patients with cardiogenic pulmonary edema : a sub-analysis of the LUNG SAFE study

Patients with acute respiratory failure caused by cardiogenic pulmonary edema (CPE) may require mechanical ventilation that can cause further lung damage. Our aim was to determine the impact of ventilatory settings on CPE mortality. Patients from the LUNG SAFE cohort, a multicenter prospective cohort study of patients undergoing mechanical ventilation, were studied. Relationships between ventilatory parameters and outcomes (ICU discharge/hospital mortality) were assessed using latent mixture analysis and a marginal structural model. From 4499 patients, 391 meeting CPE criteria (median age 70 [interquartile range 59-78], 40% female) were included. ICU and hospital mortality were 34% and 40%, respectively. ICU survivors were younger (67 [57-77] vs 74 [64-80] years, p < 0.001) and had lower driving (12 [8-16] vs 15 [11-17] cmHO, p < 0.001), plateau (20 [15-23] vs 22 [19-26] cmHO, p < 0.001) and peak (21 [17-27] vs 26 [20-32] cmHO, p < 0.001) pressures. Latent mixture analysis of patients receiving invasive mechanical ventilation on ICU day 1 revealed a subgroup ventilated with high pressures with lower probability of being discharged alive from the ICU (hazard ratio [HR] 0.79 [95% confidence interval 0.60-1.05], p = 0.103) and increased hospital mortality (HR 1.65 [1.16-2.36], p = 0.005). In a marginal structural model, driving pressures in the first week (HR 1.12 [1.06-1.18], p < 0.001) and tidal volume after day 7 (HR 0.69 [0.52-0.93], p = 0.015) were related to survival. Higher airway pressures in invasively ventilated patients with CPE are related to mortality. These patients may be exposed to an increased risk of ventilator-induced lung injury. Trial registration Clinicaltrials.gov NCT02010073

Measurement of inclusive and differential cross sections for single top quark production in association with a W boson in proton-proton collisions at s \sqrt{s} = 13 TeV

International audienceMeasurements of the inclusive and normalised differential cross sections are presented for the production of single top quarks in association with a W boson in proton-proton collisions at a centre-of-mass energy of 13 TeV. The data used were recorded with the CMS detector at the LHC during 2016–2018, and correspond to an integrated luminosity of 138 fb$^{−1}$. Events containing one electron and one muon in the final state are analysed. For the inclusive measurement, a multivariate discriminant, exploiting the kinematic properties of the events is used to separate the signal from the dominant $\textrm{t}\overline{\textrm{t}}$ background. A cross section of $79.2\pm 0.9{\left(\textrm{stat}\right)}_{-8.0}^{+7.7}\left(\textrm{syst}\right)\pm 1.2\left(\textrm{lumi}\right)$ pb is obtained, consistent with the predictions of the standard model. For the differential measurements, a fiducial region is defined according to the detector acceptance, and the requirement of exactly one jet coming from the fragmentation of a bottom quark. The resulting distributions are unfolded to particle level and agree with the predictions at next-to-leading order in perturbative quantum chromodynamics.[graphic not available: see fulltext

Search for pair production of vector-like quarks in leptonic final states in proton-proton collisions at s \sqrt{s} = 13 TeV

A search is presented for vector-like $\mathrm{T}$ and $\mathrm{B}$ quark-antiquark pairs produced in proton-proton collisions at a center-of-mass energy of 13 TeV. Data were collected by the CMS experiment at the CERN LHC in 2016-2018, with an integrated luminosity of 138 fb$^{-1}$. Events are separated into single-lepton, same-sign charge dilepton, and multilepton channels. In the analysis of the single-lepton channel a multilayer neural network and jet identification techniques are employed to select signal events, while the same-sign dilepton and multilepton channels rely on the high-energy signature of the signal to distinguish it from standard model backgrounds. The data are consistent with standard model background predictions, and the production of vector-like quark pairs is excluded at 95% confidence level for $\mathrm{T}$ quark masses up to 1.54 TeV and $\mathrm{B}$ quark masses up to 1.56 TeV, depending on the branching fractions assumed, with maximal sensitivity to decay modes that include multiple top quarks. The limits obtained in this search are the strongest limits to date for $\mathrm{T} \overline{\mathrm{T}}$ production, excluding masses below 1.48 TeV for all decays to third generation quarks, and are the strongest limits to date for $\mathrm{B} \overline{\mathrm{B}}$ production with $\mathrm{B}$ quark decays to tW.A search is presented for vector-like T and B quark-antiquark pairs produced in proton-proton collisions at a center-of-mass energy of 13 TeV. Data were collected by the CMS experiment at the CERN LHC in 2016–2018, with an integrated luminosity of 138 fb$^{−1}$. Events are separated into single-lepton, same-sign charge dilepton, and multi-lepton channels. In the analysis of the single-lepton channel a multilayer neural network and jet identification techniques are employed to select signal events, while the same-sign dilepton and multilepton channels rely on the high-energy signature of the signal to distinguish it from standard model backgrounds. The data are consistent with standard model background predictions, and the production of vector-like quark pairs is excluded at 95% confidence level for T quark masses up to 1.54 TeV and B quark masses up to 1.56 TeV, depending on the branching fractions assumed, with maximal sensitivity to decay modes that include multiple top quarks. The limits obtained in this search are the strongest limits to date for $\textrm{T}\overline{\textrm{T}}$ production, excluding masses below 1.48 TeV for all decays to third generation quarks, and are the strongest limits to date for $\textrm{B}\overline{\textrm{B}}$ production with B quark decays to tW.[graphic not available: see fulltext]A search is presented for vector-like T and B quark-antiquark pairs produced in proton-proton collisions at a center-of-mass energy of 13 TeV. Data were collected by the CMS experiment at the CERN LHC in 2016-2018, with an integrated luminosity of 138 fb$^{-1}$. Events are separated into single-lepton, same-sign charge dilepton, and multilepton channels. In the analysis of the single-lepton channel a multilayer neural network and jet identification techniques are employed to select signal events, while the same-sign dilepton and multilepton channels rely on the high-energy signature of the signal to distinguish it from standard model backgrounds. The data are consistent with standard model background predictions, and the production of vector-like quark pairs is excluded at 95% confidence level for T quark masses up to 1.54 TeV and B quark masses up to 1.56 TeV, depending on the branching fractions assumed, with maximal sensitivity to decay modes that include multiple top quarks. The limits obtained in this search are the strongest limits to date for $\mathrm{T\overline{T}}$ production, excluding masses below 1.48 TeV for all decays to third generation quarks, and are the strongest limits to date for $\mathrm{B\overline{B}}$ production with B quark decays to tW

Measurement of the Higgs boson inclusive and differential fiducial production cross sections in the diphoton decay channel with pp collisions at s \sqrt{s} = 13 TeV

International audienceThe measurements of the inclusive and differential fiducial cross sections of the Higgs boson decaying to a pair of photons are presented. The analysis is performed using proton-proton collisions data recorded with the CMS detector at the LHC at a centre-of-mass energy of 13 TeV and corresponding to an integrated luminosity of 137 fb$^{−1}$. The inclusive fiducial cross section is measured to be ${\sigma}_{\textrm{fid}}={73.4}_{-5.3}^{+5.4}{\left(\textrm{stat}\right)}_{-2.2}^{+2.4}\left(\textrm{syst}\right)$ fb, in agreement with the standard model expectation of 75.4 ± 4.1 fb. The measurements are also performed in fiducial regions targeting different production modes and as function of several observables describing the diphoton system, the number of additional jets present in the event, and other kinematic observables. Two double differential measurements are performed. No significant deviations from the standard model expectations are observed.[graphic not available: see fulltext

Search for heavy resonances and quantum black holes in eμ\mu, eτ\tau, and μτ\mu\tau final states in proton-proton collisions at s\sqrt{s} = 13 TeV

A search is reported for heavy resonances and quantum black holes decaying into e$\mu$, e$\tau$, and $\mu\tau$ final states in proton-proton collision data recorded by the CMS experiment at the CERN LHC during 2016-2018 at $\sqrt{s} =$ 13 TeV, corresponding to an integrated luminosity of 138 fb$^{-1}$. The e$\mu$, e$\tau$, and $\mu\tau$ invariant mass spectra are reconstructed, and no evidence is found for physics beyond the standard model. Upper limits are set at 95% confidence level on the product of the cross section and branching fraction for lepton flavor violating signals. Three benchmark signals are studied: resonant $\tau$ sneutrino production in $R$ parity violating supersymmetric models, heavy Z' gauge bosons with lepton flavor violating decays, and nonresonant quantum black hole production in models with extra spatial dimensions. Resonant $\tau$ sneutrinos are excluded for masses up to 4.2 TeV in the e$\mu$ channel, 3.7 TeV in the e$\tau$ channel, and 3.6 TeV in the $\mu\tau$ channel. A Z' boson with lepton flavor violating couplings is excluded up to a mass of 5.0 TeV in the e$\mu$ channel, up to 4.3 TeV in the e$\tau$ channel, and up to 4.1 TeV in the $\mu\tau$ channel. Quantum black holes in the benchmark model are excluded up to the threshold mass of 5.6 TeV in the e$\mu$ channel, 5.2 TeV in the e$\tau$ channel, and 5.0 TeV in the $\mu\tau$ channel. In addition, model-independent limits are extracted to allow comparisons with other models for the same final states and similar event selection requirements. The results of these searches provide the most stringent limits available from collider experiments for heavy particles that undergo lepton flavor violating decays.A search is reported for heavy resonances and quantum black holes decaying into eμ, eτ, and μτ final states in proton-proton collision data recorded by the CMS experiment at the CERN LHC during 2016–2018 at $\sqrt{s}$ = 13 TeV, corresponding to an integrated luminosity of 138 fb$^{−1}$. The eμ, eτ, and μτ invariant mass spectra are reconstructed, and no evidence is found for physics beyond the standard model. Upper limits are set at 95% confidence level on the product of the cross section and branching fraction for lepton flavor violating signals. Three benchmark signals are studied: resonant τ sneutrino production in R parity violating supersymmetric models, heavy Z′ gauge bosons with lepton flavor violating decays, and nonresonant quantum black hole production in models with extra spatial dimensions. Resonant τ sneutrinos are excluded for masses up to 4.2TeV in the eμ channel, 3.7TeV in the eτ channel, and 3.6TeV in the μτ channel. A Z′ boson with lepton flavor violating couplings is excluded up to a mass of 5.0TeV in the eμ channel, up to 4.3Te V in the eτ channel, and up to 4.1TeV in the μτ channel. Quantum black holes in the benchmark model are excluded up to the threshold mass of 5.6TeV in the eμ channel, 5.2TeV in the eτ channel, and 5.0TeV in the μτ channel. In addition, model-independent limits are extracted to allow comparisons with other models for the same final states and similar event selection requirements. The results of these searches provide the most stringent limits available from collider experiments for heavy particles that undergo lepton flavor violating decays.[graphic not available: see fulltext]A search is reported for heavy resonances and quantum black holes decaying into e$\mu$, e$\tau$, and $\mu\tau$ final states in proton-proton collision data recorded by the CMS experiment at the CERN LHC during 2016-2018 at $\sqrt{s}$ = 13 TeV, corresponding to an integrated luminosity of 138 fb$^{-1}$. The e$\mu$, e$\tau$, and $\mu\tau$ invariant mass spectra are reconstructed, and no evidence is found for physics beyond the standard model. Upper limits are set at 95% confidence level on the product of the cross section and branching fraction for lepton flavor violating signals. Three benchmark signals are studied: resonant $\tau$ sneutrino production in $R$ parity violating supersymmetric models, heavy Z' gauge bosons with lepton flavor violating decays, and nonresonant quantum black hole production in models with extra spatial dimensions. Resonant $\tau$ sneutrinos are excluded for masses up to 4.2 TeV in the e$\mu$ channel, 3.7 TeV in the e$\tau$ channel, and 3.6 TeV in the $\mu\tau$ channel. A Z' boson with lepton flavor violating couplings is excluded up to a mass of 5.0 TeV in the e$\mu$ channel, up to 4.3 TeV in the e$\tau$ channel, and up to 4.1 TeV in the $\mu\tau$ channel. Quantum black holes in the benchmark model are excluded up to the threshold mass of 5.6 TeV in the e$\mu$ channel, 5.2 TeV in the e$\tau$ channel, and 5.0 TeV in the $\mu\tau$ channel. In addition, model-independent limits are extracted to allow comparisons with other models for the same final states and similar event selection requirements. The results of these searches provide the most stringent limits available from collider experiments for heavy particles that undergo lepton flavor violating decays

Search for nonresonant Higgs boson pair production in the four leptons plus two b jets final state in proton-proton collisions at s=\sqrt{s} = 13 TeV

The first search for nonresonant production of Higgs boson pairs (HH) with one H decaying into four leptons and the other into a pair of b quarks is presented, using proton-proton collisions recorded at a center-of-mass energy of $\sqrt{s} =$ 13 TeV by the CMS experiment. The analyzed data correspond to an integrated luminosity of 138 fb$^{-1}$. A 95% confidence level upper limit of 32.4 is set on the signal strength modifier $\mu$, defined as the ratio of the observed HH production rate in the ${\mathrm{H}\mathrm{H}} \to\mathrm{Z}\mathrm{Z}^{*}\mathrm{b}\mathrm{\bar{b}}\to 4\ell\mathrm{b}\mathrm{\bar{b}}$ decay channel to the standard model expectation. Possible modifications of the H trilinear coupling $\lambda_\text{HHH}$ with respect to the standard model (SM) value are investigated. The coupling modifier $\kappa_{\lambda}$, defined as $\lambda_\text{HHH}$ divided by its SM prediction, is constrained to be within the observed (expected) range $-$8.8 ($-$9.8) $< \kappa_{\lambda} <$ 13.4 (15.0) at 95% confidence level.The first search for nonresonant production of Higgs boson pairs (HH) with one H decaying into four leptons and the other into a pair of b quarks is presented, using proton-proton collisions recorded at a center-of-mass energy of $\sqrt{s}$ = 13 TeV by the CMS experiment. The analyzed data correspond to an integrated luminosity of 138 fb$^{−1}$. A 95% confidence level upper limit of 32.4 is set on the signal strength modifier μ, defined as the ratio of the observed HH production rate in the $\textrm{HH}\to {\textrm{ZZ}}^{\ast}\textrm{b}\overline{\textrm{b}}\to 4\ell \textrm{b}\overline{\textrm{b}}$ decay channel to the standard model (SM) expectation. Possible modifications of the H trilinear coupling λ$_{HHH}$ with respect to the SM value are investigated. The coupling modifier κ$_{λ}$, defined as λ$_{HHH}$ divided by its SM prediction, is constrained to be within the observed (expected) range −8.8 (−9.8) < κ$_{λ}$< 13.4 (15.0) at 95% confidence level.[graphic not available: see fulltext]The first search for nonresonant production of Higgs boson pairs (HH) with one H decaying into four leptons and the other into a pair of b quarks is presented, using proton-proton collisions recorded at a center-of-mass energy of $\sqrt{s}$ = 13 TeV by the CMS experiment. The analyzed data correspond to an integrated luminosity of 138 fb$^{-1}$. A 95% confidence level upper limit of 32.4 is set on the signal strength modifier $\mu$, defined as the ratio of the observed HH production rate in the HH $\to$ ZZ*b$\mathrm{\bar{b}}$ $\to$ 4$\ell$b$\mathrm{\bar{b}}$ decay channel to the standard model expectation. Possible modifications of the H trilinear coupling $\lambda_\text{HHH}$ with respect to the standard model (SM) value are investigated. The coupling modifier $\kappa_{\lambda}$, defined as $\lambda_\text{HHH}$ divided by its SM prediction, is constrained to be within the observed (expected) range -8.8 (-9.8) $<$ $\kappa_{\lambda}$ $<$ 13.4 (15.0) at 95% confidence level

Measurement of the top quark pole mass using tt‾ \textrm{t}\overline{\textrm{t}} +jet events in the dilepton final state in proton-proton collisions at s \sqrt{s} = 13 TeV

A measurement of the top quark pole mass ${{m_{\mathrm{t}}} ^{\text{pole}}}$ in events where a top quark-antiquark pair ($\mathrm{t\bar{t}}$) is produced in association with at least one additional jet ($\mathrm{t\bar{t}}$+jet) is presented. This analysis is performed using proton-proton collision data at $\sqrt{s} =$ 13 TeV collected by the CMS experiment at the CERN LHC, corresponding to a total integrated luminosity of 36.3 fb$^{-1}$. Events with two opposite-sign leptons in the final state (e$^{+}$e$^{-}$, $\mu^{+}\mu^{-}$, e$^{\pm}\mu^{\mp}$) are analyzed. The reconstruction of the main observable and the event classification are optimized using multivariate analysis techniques based on machine learning. The production cross section is measured as a function of the inverse of the invariant mass of the $\mathrm{t\bar{t}}$+jet system at the parton level using a maximum likelihood unfolding. Given a reference parton distribution function (PDF), the top quark pole mass is extracted using the theoretical predictions at next-to-leading order. For the ABMP16NLO PDF, this results in ${{m_{\mathrm{t}}} ^{\text{pole}}} =$ 172.94 $\pm$ 1.37 GeV.A measurement of the top quark pole mass ${m}_{\textrm{t}}^{\textrm{pole}}$ in events where a top quark-antiquark pair ($\textrm{t}\overline{\textrm{t}}$) is produced in association with at least one additional jet ($\textrm{t}\overline{\textrm{t}}$+jet) is presented. This analysis is performed using proton-proton collision data at $\sqrt{s}$ = 13 TeV collected by the CMS experiment at the CERN LHC, corresponding to a total integrated luminosity of 36.3 fb$^{−1}$. Events with two opposite-sign leptons in the final state (e$^{+}$e$^{−}$, μ$^{+}$μ$^{−}$, e$^{±}$μ$^{∓}$) are analyzed. The reconstruction of the main observable and the event classification are optimized using multivariate analysis techniques based on machine learning. The production cross section is measured as a function of the inverse of the invariant mass of the $\textrm{t}\overline{\textrm{t}}$+jet system at the parton level using a maximum likelihood unfolding. Given a reference parton distribution function (PDF), the top quark pole mass is extracted using the theoretical predictions at next-to-leading order. For the ABMP16NLO PDF, this results in ${m}_{\textrm{t}}^{\textrm{pole}}$ = 172.93 ± 1.36 GeV.[graphic not available: see fulltext]A measurement of the top quark pole mass $m_\mathrm{t}^\text{pole}$ in events where a top quark-antiquark pair ($\mathrm{t\bar{t}}$) is produced in association with at least one additional jet ($\mathrm{t\bar{t}}$+jet) is presented. This analysis is performed using proton-proton collision data at $\sqrt{s}$ = 13 TeV collected by the CMS experiment at the CERN LHC, corresponding to a total integrated luminosity of 36.3 fb$^{-1}$. Events with two opposite-sign leptons in the final state (e$^+$e$^-$, $\mu^+\mu^-$, e$^\pm\mu^\mp$) are analyzed. The reconstruction of the main observable and the event classification are optimized using multivariate analysis techniques based on machine learning. The production cross section is measured as a function of the inverse of the invariant mass of the $\mathrm{t\bar{t}}$+jet system at the parton level using a maximum likelihood unfolding. Given a reference parton distribution function (PDF), the top quark pole mass is extracted using the theoretical predictions at next-to-leading order. For the ABMP16NLO PDF, this results in $m_\mathrm{t}^\text{pole}$ = 172.93 $\pm$ 1.36 GeV

Search for resonant and nonresonant production of pairs of dijet resonances in proton-proton collisions at s \sqrt{s} = 13 TeV

International audienceA search for pairs of dijet resonances with the same mass is conducted in final states with at least four jets. Results are presented separately for the case where the four jet production proceeds via an intermediate resonant state and for nonresonant production. The search uses a data sample corresponding to an integrated luminosity of 138 fb$^{−1}$ collected by the CMS detector in proton-proton collisions at $\sqrt{s}$ = 13 TeV. Model-independent limits, at 95% confidence level, are reported on the production cross section of four-jet and dijet resonances. These first LHC limits on resonant pair production of dijet resonances via high mass intermediate states are applied to a signal model of diquarks that decay into pairs of vector-like quarks, excluding diquark masses below 7.6 TeV for a particular model scenario. There are two events in the tails of the distributions, each with a four-jet mass of 8 TeV and an average dijet mass of 2 TeV, resulting in local and global significances of 3.9 and 1.6 standard deviations, respectively, if interpreted as a signal. The nonresonant search excludes pair production of top squarks with masses between 0.50 TeV to 0.77 TeV, with the exception of a small interval between 0.52 and 0.58 TeV, for supersymmetric R-parity-violating decays to quark pairs, significantly extending previous limits. Here, the most significant excess above the predicted background occurs at an average dijet mass of 0.95 TeV, for which the local and global significances are 3.6 and 2.5 standard deviations, respectively.[graphic not available: see fulltext