Analisis Komponen SIRS (Systemic Inflammatory Response Syndrome) sebagai Prediktor Outcome Pasien Cedera Kepala.

Cedera kepala merupakan cedera yang paling banyak terjadi di antara cedera lainnya. Studi pendahuluan yang dilakukan di instalasi gawat darurat Rumah Sakit Umum Daerah Ulin Banjarmasin menunjukkan bahwa terdapat 1070 kasus cedera kepala selama kurun waktu 10 bulan (Januari sampai Oktober 2017), dengan angka kejadian cedera kepala ringan, sedang, dan berat masing-masing 798, 150, dan 122 kasus. Adapun angka kematian pasien cedera kepala berat selama 10 bulan tersebut mencapai 63 kasus atau sebanyak 52%. Kejadian kematian pada pasien cedera kepala berhubungan dengan mekanisme cedera otak traumatik, khususnya melalui proses inflamasi. Selama proses inflamasi ini berlangsung, secara klinis akan muncul berbagai respon yang dapat diobservasi, dikenal dengan istilah SIRS (Systemic Inflammatory Response Syndrome). Komponen-komponennya meliputi suhu tubuh, frekuensi denyut nadi, frekuensi pernapasan, dan nilai hitung leukosit. Munculnya SIRS tentu bukan merupakan pertanda yang baik bagi pasien. Karenanya, perawat perlu untuk mendeteksi resiko kematian yang mungkin terjadi melalui mekanisme ini. Berbagai macam skoring telah dikembangkan untuk menilai outcome pasien cedera kepala, salah satunya adalah GAP score. Penilaian dilakukan terhadap tingkat kesadaran pasien yang diukur menggunakan Glasgow Coma Scale (GCS), usia, dan tekanan darah sistolik. Penelitian terdahulu menyatakan bahwa GAP score merupakan prediktor yang baik untuk meramalkan kematian pasien cedera kepala, bahkan lebih akurat dibandingkan RTS. Tingkat probabilitasnya mencapai 97,6% untuk memprediksi kematian pasien cedera kepala. Oleh karenanya, peneliti merasa tertarik meneliti lebih dalam mengenai hal tersebut. Peneliti melakukan penelitian dengan tujuan untuk membuktikan bahwa komponen SIRS (systematic inflammatory response syndrome) dapat memprediksi outcome pasien cedera kepala berdasarkan GAP score. Penelitian dilakukan dengan menggunakan desain analitik observasional dan pendekatan cross sectional. Penelitian yang dilakukan di IGD RSUD Ulin Banjarmasin antara tanggal 20 April 2018 sampai dengan 30 Mei 2018 ini memiliki populasi yaitu seluruh pasien cedera kepala yang dibawa ke IGD. Kemudian dilakukan pemilihan sampel menggunakan teknik purposive sampling dengan jumlah sampel sebanyak 80. Pengumpulan data dilakukan dengan menggunakan lembar observasi yang berisi identitas pasien, kolom untuk mengisi nilai dari masing-masing komponen SIRS dan GAP score, serta identitas pengambil data. Pengumpulan dilakukan 1 kali segera setelah pasien masuk IGD. Data yang didapatkan kemudian dianalisis menggunakan SPSS. Hasil analisis data bivariat menunjukkan bahwa suhu tubuh, frekuensi pernapasan, dan nilai hitung leukosit memiliki perbedaan korelasi dengan GAP score (p suhu tubuh = 0,000; p frekuensi pernapasan = 0,003; dan p nilai hitung leukosit = 0,042). Nilai korelasi spearman pada variabel suhu tubuh sebesar -0,513 yang berarti arah korelasi negatif dengan kekuatan korelasi yang kuat. Variabel frekuensi pernapasan dan nilai hitung leukosit menghasilkan nilai korelasi berturut-turut yaitu r = -0,327 dan -0,228, menunjukkan arah korelasi yang negatif. Adapun kekuatan korelasi untuk variabel frekuensi pernapasan adalah sedang, dan kekuatan korelasi untuk variabel nilai hitung leukosit adalah kuat. Hasil analisis antara frekuensi denyut nadi dan GAP score menghasilkan p = 0,334. Hal tersebut menunjukkan tidak adanya perbedaan korelasi di antara keduanya. Oleh karenanya, hanya 3 dari 4 komponen SIRS yang dapat dilanjutkan ke analisis multivariat menggunakan regresi linear. Uji multivariat yang dilakukan dengan metode backward menghasilkan sebuah persamaan sebagai berikut : y = 7,841 - 3,757 (suhu tubuh) – 0,590 (nilai hitung leukosit) Nilai uji kalibrasinya = 0,000 dan uji deskriminasinya = 0,361. Dengan demikian dapat disimpulkan bahwa suhu tubuh dan nilai hitung leukosit dapat dijadikan sebagai prediktor outcome pasien cedera kepala berdasarkan GAP score. Namun demikian, persamaan ini hanya dapat memprediksi sebanyak 36,1%, sedangkan 63,9% lainnya ditentukan oleh faktor yang lain. Faktor-faktor yang dimaksud meliputi : 1). Hipotensi; semakin rendah tekanan darahnya, akan semakin buruk outcome pasiennya, 2). Hipotermia; pasien yang didinginkan hingga 320C dalam waktu 6 jam dari cedera memiliki hasil yang baik dibandingkan dengan yang dipertahankan pada 370C, 3). Perubahan elektrolit; homeostasis ionik dan neurotransmiter yang terganggu diakui sebagai mekanisme paling penting yang berkontribusi terhadap perkembangan pembengkakan otak sekunder, 4). Multiple trauma; pasien cedera kepala yang diikuti dengan cedera dada atau cedera abdomen dapat memperburuk prognosis pasien, 5). Jenis kelamin; perempuan 1,75 kali lebih mungkin mati karena cedera otak dibandingkan laki-laki, dan 1,57 kali lebih mungkin mengalami hasil yang buruk dibandingkan laki-laki, dan 6). Penilaian neurologis; semakin baik kondisi neurologis pasien saat datang, semakin baik pula outcome pasien tersebut. Kesimpulan dalam penelitian ini adalah bahwa secara statistik, suhu tubuh, frekuensi pernapasan, dan nilai hitung leukosit memiliki hubungan dengan outcome pasien cedera kepala yang dinilai menggunakan GAP score. Namun, hanya suhu tubuh dan nilai hitung leukosit yang dapat dijadikan prediktor outcome pasien cedera kepala berdasarkan GAP score

Sphalerons and the Electroweak Phase Transition in Models with Higher Scalar Representations

In this work we investigate the sphaleron solution in a $SU(2)\times U(1)_X$ gauge theory, which also encompasses the Standard Model, with higher scalar representation(s) ($J^{(i)},X^{(i)}$). We show that the field profiles describing the sphaleron in higher scalar multiplet, have similar trends like the doublet case with respect to the radial distance. We compute the sphaleron energy and find that it scales linearly with the vacuum expectation value of the scalar field and its slope depends on the representation. We also investigate the effect of $U(1)$ gauge field and find that it is small for the physical value of the mixing angle, $\theta_{W}$ and resembles the case for the doublet. For higher representations, we show that the criterion for strong first order phase transition, $v_{c}/T_{c}>\eta$, is relaxed with respect to the doublet case, i.e. $\eta<1$.Comment: 20 pages, 5 figures & 1 table, published versio

Measurement and interpretation of same-sign W boson pair production in association with two jets in pp collisions at s = 13 TeV with the ATLAS detector

This paper presents the measurement of fducial and diferential cross sections for both the inclusive and electroweak production of a same-sign W-boson pair in association with two jets (W±W±jj) using 139 fb−1 of proton-proton collision data recorded at a centre-of-mass energy of √s = 13 TeV by the ATLAS detector at the Large Hadron Collider. The analysis is performed by selecting two same-charge leptons, electron or muon, and at least two jets with large invariant mass and a large rapidity diference. The measured fducial cross sections for electroweak and inclusive W±W±jj production are 2.92 ± 0.22 (stat.) ± 0.19 (syst.)fb and 3.38±0.22 (stat.)±0.19 (syst.)fb, respectively, in agreement with Standard Model predictions. The measurements are used to constrain anomalous quartic gauge couplings by extracting 95% confdence level intervals on dimension-8 operators. A search for doubly charged Higgs bosons H±± that are produced in vector-boson fusion processes and decay into a same-sign W boson pair is performed. The largest deviation from the Standard Model occurs for an H±± mass near 450 GeV, with a global signifcance of 2.5 standard deviations

Search for pair production of squarks or gluinos decaying via sleptons or weak bosons in final states with two same-sign or three leptons with the ATLAS detector

A search for pair production of squarks or gluinos decaying via sleptons or weak bosons is reported. The search targets a final state with exactly two leptons with same-sign electric charge or at least three leptons without any charge requirement. The analysed data set corresponds to an integrated luminosity of 139 fb−1 of proton-proton collisions collected at a centre-of-mass energy of 13 TeV with the ATLAS detector at the LHC. Multiple signal regions are defined, targeting several SUSY simplified models yielding the desired final states. A single control region is used to constrain the normalisation of the WZ + jets background. No significant excess of events over the Standard Model expectation is observed. The results are interpreted in the context of several supersymmetric models featuring R-parity conservation or R-parity violation, yielding exclusion limits surpassing those from previous searches. In models considering gluino (squark) pair production, gluino (squark) masses up to 2.2 (1.7) TeV are excluded at 95% confidence level

Combination of searches for heavy spin-1 resonances using 139 fb−1 of proton-proton collision data at s = 13 TeV with the ATLAS detector

A combination of searches for new heavy spin-1 resonances decaying into different pairings of W, Z, or Higgs bosons, as well as directly into leptons or quarks, is presented. The data sample used corresponds to 139 fb−1 of proton-proton collisions at = 13 TeV collected during 2015–2018 with the ATLAS detector at the CERN Large Hadron Collider. Analyses selecting quark pairs (qq, bb, , and tb) or third-generation leptons (τν and ττ) are included in this kind of combination for the first time. A simplified model predicting a spin-1 heavy vector-boson triplet is used. Cross-section limits are set at the 95% confidence level and are compared with predictions for the benchmark model. These limits are also expressed in terms of constraints on couplings of the heavy vector-boson triplet to quarks, leptons, and the Higgs boson. The complementarity of the various analyses increases the sensitivity to new physics, and the resulting constraints are stronger than those from any individual analysis considered. The data exclude a heavy vector-boson triplet with mass below 5.8 TeV in a weakly coupled scenario, below 4.4 TeV in a strongly coupled scenario, and up to 1.5 TeV in the case of production via vector-boson fusion

Software Performance of the ATLAS Track Reconstruction for LHC Run 3

Charged particle reconstruction in the presence of many simultaneous proton–proton (pp) collisions in the LHC is a challenging task for the ATLAS experiment’s reconstruction software due to the combinatorial complexity. This paper describes the major changes made to adapt the software to reconstruct high-activity collisions with an average of 50 or more simultaneous pp interactions per bunch crossing (pileup) promptly using the available computing resources. The performance of the key components of the track reconstruction chain and its dependence on pile-up are evaluated, and the improvement achieved compared to the previous software version is quantified. For events with an average of 60 pp collisions per bunch crossing, the updated track reconstruction is twice as fast as the previous version, without significant reduction in reconstruction efficiency and while reducing the rate of combinatorial fake tracks by more than a factor two

Performance and calibration of quark/gluon-jet taggers using 140 fb⁻¹ of pp collisions at √s=13 TeV with the ATLAS detector

The identification of jets originating from quarks and gluons, often referred to as quark/gluon tagging, plays an important role in various analyses performed at the Large Hadron Collider, as Standard Model measurements and searches for new particles decaying to quarks often rely on suppressing a large gluon-induced background. This paper describes the measurement of the efficiencies of quark/gluon taggers developed within the ATLAS Collaboration, using √s=13 TeV proton–proton collision data with an integrated luminosity of 140 fb-1 collected by the ATLAS experiment. Two taggers with high performances in rejecting jets from gluon over jets from quarks are studied: one tagger is based on requirements on the number of inner-detector tracks associated with the jet, and the other combines several jet substructure observables using a boosted decision tree. A method is established to determine the quark/gluon fraction in data, by using quark/gluon-enriched subsamples defined by the jet pseudorapidity. Differences in tagging efficiency between data and simulation are provided for jets with transverse momentum between 500 GeV and 2 TeV and for multiple tagger working points

Search for resonant production of dark quarks in the dijet final state with the ATLAS detector

This paper presents a search for a new Z′ resonance decaying into a pair of dark quarks which hadronise into dark hadrons before promptly decaying back as Standard Model particles. This analysis is based on proton-proton collision data recorded at $$\sqrt{s}$$ s = 13 TeV with the ATLAS detector at the Large Hadron Collider between 2015 and 2018, corresponding to an integrated luminosity of 139 fb−1. After selecting events containing large-radius jets with high track multiplicity, the invariant mass distribution of the two highest-transverse-momentum jets is scanned to look for an excess above a data-driven estimate of the Standard Model multijet background. No significant excess of events is observed and the results are thus used to set 95% confidence-level upper limits on the production cross-section times branching ratio of the Z′ to dark quarks as a function of the Z′ mass for various dark-quark scenarios

Electron and photon energy calibration with the ATLAS detector using LHC Run 2 data

This paper presents the electron and photon energy calibration obtained with the ATLAS detector using 140 fb-1 of LHC proton-proton collision data recorded at √(s) = 13 TeV between 2015 and 2018. Methods for the measurement of electron and photon energies are outlined, along with the current knowledge of the passive material in front of the ATLAS electromagnetic calorimeter. The energy calibration steps are discussed in detail, with emphasis on the improvements introduced in this paper. The absolute energy scale is set using a large sample of Z-boson decays into electron-positron pairs, and its residual dependence on the electron energy is used for the first time to further constrain systematic uncertainties. The achieved calibration uncertainties are typically 0.05% for electrons from resonant Z-boson decays, 0.4% at ET ∼ 10 GeV, and 0.3% at ET ∼ 1 TeV; for photons at ET ∼ 60 GeV, they are 0.2% on average. This is more than twice as precise as the previous calibration. The new energy calibration is validated using J/ψ → ee and radiative Z-boson decays