Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Background: Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. // Methods: We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung's disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. // Findings: We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung's disease) from 264 hospitals (89 in high-income countries, 166 in middle-income countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in low-income countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. // Interpretation: Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between low-income, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Search for narrow resonances and quantum black holes in inclusive and b-tagged dijet mass spectra from pp collisions at root s=7 TeV

A search for narrow resonances and quantum black holes is performed in inclusive and b-tagged dijet mass spectra measured with the CMS detector at the LHC. The data set corresponds to 5 fb(-1) of integrated luminosity collected in pp collisions at root s = 7 TeV. No narrow resonances or quantum black holes are observed. Model-independent upper limits at the 95% confidence level are obtained on the product of the cross section, branching fraction into dijets, and acceptance for three scenarios: decay into quark-quark, quark-gluon, and gluon-gluon pairs. Specific lower limits are set on the mass of string resonances (4.31 TeV), excited quarks (3.32 TeV), axigluons and colorons (3.36 TeV), scalar color-octet resonances (2.07 TeV), E-6 diquarks (3.75 TeV), and on the masses of W' (1.92 TeV) and Z' (1.47 TeV) bosons. The limits on the minimum mass of quantum black holes range from 4 to 5.3 TeV. In addition, b-quark tagging is applied to the two leading jets and upper limits are set on the production of narrow dijet resonances in a model-independent fashion as a function of the branching fraction to b-jet pairs

Measurement of associated production of vector bosons and top quark-antiquark pairs in pp collisions at root s=7 TeV

The first measurement of vector-boson production associated with a top quark-antiquark pair in proton-proton collisions at root s = 7 TeV is presented. The results are based on a data set corresponding to an integrated luminosity of 5.0 fb(-1), recorded by the CMS detector at the LHC in 2011. The measurement is performed in two independent channels through a trilepton analysis of t (t) over barZ events and a same-sign dilepton analysis of t (t) over barV (V = W or Z) events. In the trilepton channel a direct measurement of the t (t) over barZ cross section sigma(t (t) over barZ) = 0.28(-0.11)(+0.14) (stat)(-0.03)(+0.06) (syst) pb is obtained. In the dilepton channel a measurement of the t (t) over barV cross section yields sigma(t (t) over barV) = 0.43(-0.15)(+0.17) (stat)(-0.07)(+0.09) (syst) pb. These measurements have a significance, respectively, of 3.3 and 3.0 standard deviations from the background hypotheses and are compatible, within uncertainties, with the corresponding next-to-leading order predictions of 0.137(-0.016)(+0.012) and 0.306(-0.053)(+0.031) pb. DOI: 10.1103/PhysRevLett.110.17200

Search for a Higgs boson decaying into a b-quark pair and produced in association with b quarks in proton-proton collisions at 7 TeV

A search for a neutral Higgs boson decaying to a pair of b quarks, and produced in association with at least one additional b quark, is presented. Multijet final states with three jets identified as originating from b quarks, at least one of which may include a non-isolated muon, are studied. The data used in this analysis correspond to an integrated luminosity of 2.7-4.8 fb(-1), collected by the CMS experiment in proton-proton collisions at the LHC at a center-of-mass energy of 7 TeV. This search is particularly sensitive to Higgs bosons in scenarios of the Minimal Supersymmetric Model (MSSM) with large values of tan beta. No excess over the predicted background from standard model processes is observed. Stringent upper limits on cross section times branching fraction are derived and interpreted as bounds in the MSSM tan beta and m(A) parameter-space. Observed 95% confidence level upper limits reach as low as tang beta approximate to 18 for M-A approximate to 100 GeV

Study of the Mass and Spin-Parity of the Higgs Boson Candidate via Its Decays to Z Boson Pairs

A study is presented of the mass and spin-parity of the new boson recently observed at the LHC at a mass near 125 GeV. An integrated luminosity of 17: 3 fb(-1), collected by the CMS experiment in proton-proton collisions at center-of-mass energies of 7 and 8 TeV, is used. The measured mass in the ZZ channel, where both Z bosons decay to e or mu pairs, is 126: 2 +/- 0.6(stat) +/- 0. 2(syst) GeV. The angular distributions of the lepton pairs in this channel are sensitive to the spin-parity of the boson. Under the assumption of spin 0, the present data are consistent with the pure scalar hypothesis, while disfavoring the pure pseudoscalar hypothesis

Search for new physics with a monojet and missing transverse energy in pp collisions at √s=7 TeV

This is the pre-print version of the Published Article which can be accessed at the link below.A study of events with missing transverse energy and an energetic jet is performed using pp collision data at a center-of-mass energy of 7 TeV. The data were collected by the CMS detector at the LHC, and correspond to an integrated luminosity of 36  pb-1. An excess of these events over standard model contributions is a signature of new physics such as large extra dimensions and unparticles. The number of observed events is in good agreement with the prediction of the standard model, and significant extension of the current limits on parameters of new physics benchmark models is achieved

Search for narrow resonances using the dijet mass spectrum in pp collisions at root s=8 TeV

Results are presented of a search for the production of new particles decaying to pairs of partons (quarks, antiquarks, or gluons), in the dijet mass spectrum in proton-proton collisions at root s = 8 TeV. The data sample corresponds to an integrated luminosity of 4.0 fb(-1), collected with the CMS detector at the LHC in 2012. No significant evidence for narrow resonance production is observed. Upper limits are set at the 95% confidence level on the production cross section of hypothetical new particles decaying to quark-quark, quark-gluon, or gluon-gluon final states. These limits are then translated into lower limits on the masses of new resonances in specific scenarios of physics beyond the standard model. The limits reach up to 4.8 TeV, depending on the model, and extend previous exclusions from similar searches performed at lower collision energies. For the first time mass limits are set for the Randall-Sundrum graviton model in the dijet channel

Measurement of the W+W- and ZZ production cross sections in pp collisions at root s=8 TeV

The W+W- and ZZ production cross sections are measured in proton-proton collisions at root s = 8 TeV with the CMS experiment at the LHC in data samples corresponding to an integrated luminosity of up to 5.3 fb(-1). The measurements are performed in the leptonic decay modes W+W- -> l'vl '' v and ZZ -> 2l2l', where l = e, mu and l'(l '') = e, mu, tau. The measured cross sections sigma (pp -> W+W-) =, 69.9 +/- 2.8 (stat.) +/- 5.6 (syst.) 3.1 +/- (lum.) pb and sigma (pp -> ZZ) = 8.4 +/- 1.0 (stat) +/- 0.7 (syst) +/- 0.4 (lum.) pb, for both Z bosons produced in the mass region 60 < m(Z) < 120 GeV, are consistent with standard model predictions. These are the first measurements of the diboson production cross sections at root s = 8 TeV. (C) 2013 CERN. Published by Elsevier B.V. All rights reserved

Search in leptonic channels for heavy resonances decaying to long-lived neutral particles

A search is performed for heavy resonances decaying to two long-lived massive neutral particles, each decaying to leptons. The experimental signature is a distinctive topology consisting of a pair of oppositely charged leptons originating at a separated secondary vertex. Events were collected by the CMS detector at the LHC during pp collisions at root s = 7 TeV, and selected from data samples corresponding to 4.1 (5.1) fb(-1) of integrated luminosity in the electron (muon) channel. No significant excess is observed above standard model expectations, and an upper limit is set with 95% confidence level on the production cross section times the branching fraction to leptons, as a function of the long-lived massive neutral particle lifetime