Correcting for the Inflated Adult Population Denominator in An English Nationwide Health Care Cohort: Database Analysis Study

Background:Electronic health care databases are widely used for epidemiological studies. However, they may contain inactive records of individuals no longer participating in the health care system. These inactive records create a methodological challenge as they systematically appear as unexposed with no recorded outcomes. Given the widespread health care system engagement during the COVID-19 pandemic, the English National Health Service (NHS), which hosts a national pandemic planning and research dataset with linkage to COVID-19 vaccination and emergency care data, makes it an ideal setting to identify the extent of overrepresentation due to inactive health care records and assess ways to mitigate them.Objective:The objective of this study is to report any differences between the general practitioner–registered adult population size based on health care records compared to census estimates for England and to apply methodology that could be used to correct for such differences.Methods:We compared the number of adult patients within the General Practice Extraction Service Data for Pandemic Planning and Research (GDPPR) with a valid general practitioner registration as of 1st October 2021, with estimates published by the Office for National Statistics (ONS) for the English population. We used an approach adapted from a weighting method to correct for non-response bias in surveys and down-weighted individuals with no evidence of recent activity in their records.Results:There were 61,194,033 registered NHS patients (in the GDPPR) compared with 56,550,138 in the ONS census-based population. De-duplication on NHS number reduced the population to 57,876,641, including 46,835,968 adults, with the biggest overrepresented group aged 30‐45 years. Of the 46,835,986, 1,121,954 (2.4%) individuals had their initial weights down-weighted due to non-engagement with the health care system since January 2019. The down-weighting removed most of the differences between NHS and ONS populations.Conclusions:There are notable differences in the adult population size as per GDPPR when compared to census estimates. While the overall population size in the GDPPR data was seen to be inflated when compared to ONS census estimates, this was differential with respect to sociodemographic variables. A weighting-based approach can be applied to correct for the inflated denominator. Not correcting for it in large health care datasets, including the English NHS data, could introduce selection bias in epidemiological studies

First dose ChAdOx1 and BNT162b2 COVID-19 vaccinations and cerebral venous sinus thrombosis : a pooled self-controlled case series study of 11.6 million individuals in England, Scotland, and Wales

Funding: This research is part of the Data and Connectivity National Core Study, led by Health Data Research UK in partnership with the Office for National Statistics and funded by UK Research and Innovation (grant ref MC_PC_20029, AS). EAVE II is funded by the Medical Research Council (https://mrc.ukri.org/) (UKRI MC_PC 19075, AS) with the support of BREATHE, The Health Data Research Hub for Respiratory Health (MC_PC_19004, AS), which is funded through the UK Research and Innovation Industrial Strategy Challenge Fund and delivered through Health Data Research UK. This work was supported by the Con-COV team funded by the Medical Research Council (grant number: MR/V028367/1, RL). This work was supported by Health Data Research UK, which receives its funding from HDR UK Ltd (HDR-9006, RL) funded by the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Department of Health and Social Care (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation (BHF) and the Wellcome Trust. This work was supported by the ADR Wales programme of work (https://www.adruk.org/). ADR Wales is part of the Economic and Social Research Council (part of UK Research and Innovation) funded ADR UK (grant ES/S007393/1, RL). SVK acknowledges funding from NHS Research Scotland Senior Clinical Fellowship (SCAF/15/02, SVK), the MRC (MC_UU_00022/2, SVK), and the Scottish Government Chief Scientist Office (SPHSU17, SVK).Background : Several countries restricted the administration of ChAdOx1 to older age groups in 2021 over safety concerns following case reports and observed versus expected analyses suggesting a possible association with cerebral venous sinus thrombosis (CVST). Large datasets are required to precisely estimate the association between Coronavirus Disease 2019 (COVID-19) vaccination and CVST due to the extreme rarity of this event. We aimed to accomplish this by combining national data from England, Scotland, and Wales. Methods and findings : We created data platforms consisting of linked primary care, secondary care, mortality, and virological testing data in each of England, Scotland, and Wales, with a combined cohort of 11,637,157 people and 6,808,293 person years of follow-up. The cohort start date was December 8, 2020, and the end date was June 30, 2021. The outcome measure we examined was incident CVST events recorded in either primary or secondary care records. We carried out a self-controlled case series (SCCS) analysis of this outcome following first dose vaccination with ChAdOx1 and BNT162b2. The observation period consisted of an initial 90-day reference period, followed by a 2-week prerisk period directly prior to vaccination, and a 4-week risk period following vaccination. Counts of CVST cases from each country were tallied, then expanded into a full dataset with 1 row for each individual and observation time period. There was a combined total of 201 incident CVST events in the cohorts (29.5 per million person years). There were 81 CVST events in the observation period among those who a received first dose of ChAdOx1 (approximately 16.34 per million doses) and 40 for those who received a first dose of BNT162b2 (approximately 12.60 per million doses). We fitted conditional Poisson models to estimate incidence rate ratios (IRRs). Vaccination with ChAdOx1 was associated with an elevated risk of incident CVST events in the 28 days following vaccination, IRR = 1.93 (95% confidence interval (CI) 1.20 to 3.11). We did not find an association between BNT162b2 and CVST in the 28 days following vaccination, IRR = 0.78 (95% CI 0.34 to 1.77). Our study had some limitations. The SCCS study design implicitly controls for variables that are constant over the observation period, but also assumes that outcome events are independent of exposure. This assumption may not be satisfied in the case of CVST, firstly because it is a serious adverse event, and secondly because the vaccination programme in the United Kingdom prioritised the clinically extremely vulnerable and those with underlying health conditions, which may have caused a selection effect for individuals more prone to CVST. Although we pooled data from several large datasets, there was still a low number of events, which may have caused imprecision in our estimates. Conclusions : In this study, we observed a small elevated risk of CVST events following vaccination with ChAdOx1, but not BNT162b2. Our analysis pooled information from large datasets from England, Scotland, and Wales. This evidence may be useful in risk–benefit analyses of vaccine policies and in providing quantification of risks associated with vaccination to the general public.Peer reviewe

Measurement of the total cross section and ρ -parameter from elastic scattering in pp collisions at √s=13 TeV with the ATLAS detector

In a special run of the LHC with β⋆=2.5 km, proton–proton elastic-scattering events were recorded at s√=13 TeV with an integrated luminosity of 340 μb−1 using the ALFA subdetector of ATLAS in 2016. The elastic cross section was measured differentially in the Mandelstam t variable in the range from −t=2.5⋅10−4 GeV2 to −t=0.46 GeV2 using 6.9 million elastic-scattering candidates. This paper presents measurements of the total cross section σtot, parameters of the nuclear slope, and the ρ-parameter defined as the ratio of the real part to the imaginary part of the elastic-scattering amplitude in the limit t→0. These parameters are determined from a fit to the differential elastic cross section using the optical theorem and different parameterizations of the t-dependence. The results for σtot and ρ are σtot(pp→X)=104.7±1.1 mb ,ρ=0.098±0.011. The uncertainty in σtot is dominated by the luminosity measurement, and in ρ by imperfect knowledge of the detector alignment and by modelling of the nuclear amplitude.publishedVersio

The ATLAS Fast TracKer system

The ATLAS Fast TracKer (FTK) was designed to provide full tracking for the ATLAS high-level trigger by using pattern recognition based on Associative Memory (AM) chips and fitting in high-speed field programmable gate arrays. The tracks found by the FTK are based on inputs from all modules of the pixel and silicon microstrip trackers. The as-built FTK system and components are described, as is the online software used to control them while running in the ATLAS data acquisition system. Also described is the simulation of the FTK hardware and the optimization of the AM pattern banks. An optimization for long-lived particles with large impact parameter values is included. A test of the FTK system with the data playback facility that allowed the FTK to be commissioned during the shutdown between Run 2 and Run 3 of the LHC is reported. The resulting tracks from part of the FTK system covering a limited η-ϕ region of the detector are compared with the output from the FTK simulation. It is shown that FTK performance is in good agreement with the simulation

Charged-hadron production in pp, p+Pb, Pb+Pb, and Xe+Xe collisions at sNN−−−√ = 5 TeV with the ATLAS detector at the LHC

This paper presents measurements of charged-hadron spectra obtained in pp, p+Pb, and Pb+Pb collisions at s√ or sNN−−−√ = 5.02 TeV, and in Xe+Xe collisions at sNN−−−√ = 5.44 TeV. The data recorded by the ATLAS detector at the LHC have total integrated luminosities of 25 pb−1, 28 nb−1, 0.50 nb−1, and 3 μb−1, respectively. The nuclear modification factors RpPb and RAA are obtained by comparing the spectra in heavy-ion and pp collisions in a wide range of charged-particle transverse momenta and pseudorapidity. The nuclear modification factor RpPb shows a moderate enhancement above unity with a maximum at pT ≈ 3 GeV; the enhancement is stronger in the Pb-going direction. The nuclear modification factors in both Pb+Pb and Xe+Xe collisions feature a significant, centrality-dependent suppression. They show a similar distinct pT-dependence with a local maximum at pT ≈ 2 GeV and a local minimum at pT ≈ 7 GeV. This dependence is more distinguishable in more central collisions. No significant |η|-dependence is found. A comprehensive comparison with several theoretical predictions is also provided. They typically describe RAA better in central collisions and in the pT range from about 10 to 100 GeV

Search for light long-lived neutral particles that decay to collimated pairs of leptons or light hadrons in pp collisions at s√ = 13 TeV with the ATLAS detector

A search for light long-lived neutral particles with masses in the O(MeV–GeV) range is presented. The analysis targets the production of long-lived dark photons in the decay of a Higgs boson produced via gluon–gluon fusion or in association with a W boson. Events that contain displaced collimated Standard Model fermions reconstructed in the calorimeter or muon spectrometer are selected in 139 fb−1 of s√ = 13 TeV pp collision data collected by the ATLAS detector at the LHC. Background estimates for contributions from Standard Model processes and instrumental effects are extracted from data. The observed event yields are consistent with the expected background. Exclusion limits are reported on the production cross-section times branching fraction as a function of the mean proper decay length cτ of the dark photon, or as a function of the dark-photon mass and kinetic mixing parameter that quantifies the coupling between the Standard Model and potential hidden (dark) sectors. A Higgs boson branching fraction above 1% is excluded at 95% CL for a Higgs boson decaying into two dark photons for dark-photon mean proper decay lengths between 10 mm and 250 mm and dark photons with masses between 0.4 GeV and 2 GeV

Measurements of Zγ+jets differential cross sections in pp collisions at s√ = 13 TeV with the ATLAS detector

Differential cross-section measurements of Zγ production in association with hadronic jets are presented, using the full 139 fb−1 dataset of s√ = 13 TeV proton–proton collisions collected by the ATLAS detector during Run 2 of the LHC. Distributions are measured using events in which the Z boson decays leptonically and the photon is usually radiated from an initial-state quark. Measurements are made in both one and two observables, including those sensitive to the hard scattering in the event and others which probe additional soft and collinear radiation. Different Standard Model predictions, from both parton-shower Monte Carlo simulation and fixed-order QCD calculations, are compared with the measurements. In general, good agreement is observed between data and predictions from MATRIX and MiNNLOPS, as well as next-to-leading-order predictions from MADGRAPH5_AMC@NLO and SHERPA

Precision measurement of the B0 meson lifetime using B0 → J/ψ K∗0 decays with the ATLAS detector

Abstract A measurement of the $$B^{0}$$ B 0 meson lifetime using $$B^{0} \rightarrow J/\psi K^{*0}$$ B 0 → J / ψ K ∗ 0 decays in data from 13  $$\text {TeV}$$ TeV proton–proton collisions with an integrated luminosity of $$140~\mathrm {fb^{-1}}$$ 140 fb - 1 recorded by the ATLAS detector at the LHC is presented. The measured effective lifetime is $$\tau = 1.5053\pm 0.0012~\mathrm {(stat.)} \pm 0.0035~\mathrm {(syst.)~ps}.$$ τ = 1.5053 ± 0.0012 ( stat . ) ± 0.0035 ( syst . ) ps . The average decay width extracted from the effective lifetime, using parameters from external sources, is $$\begin{aligned} \Gamma _d = 0.6639\pm 0.0005~\mathrm {(stat.)} \pm 0.0016~\mathrm {(syst.)}\\ \pm 0.0038~\text {(ext.)} \text {~ps}^{-1}, \end{aligned}$$ Γ d = 0.6639 ± 0.0005 ( stat . ) ± 0.0016 ( syst . ) ± 0.0038 (ext.) ps - 1 , where the uncertainties are statistical, systematic and from external sources. The earlier ATLAS measurement of $$\Gamma _s$$ Γ s in the $$B^{0}_{s} \rightarrow J/\psi \phi$$ B s 0 → J / ψ ϕ decay was used to derive a value for the ratio of the average decay widths $$\Gamma _d$$ Γ d and $$\Gamma _s$$ Γ s for $$B^{0}$$ B 0 and $$B^{0}_{s}$$ B s 0 mesons respectively, of $$\frac{\Gamma _d }{\Gamma _s } = 0.9905\pm 0.0022~\text {(stat.)} \pm 0.0036~\text {(syst.)} \pm 0.0057~\text {(ext.)}.$$ Γ d Γ s = 0.9905 ± 0.0022 (stat.) ± 0.0036 (syst.) ± 0.0057 (ext.) . The measured lifetime, average decay width and decay width ratio are in agreement with theoretical predictions and with measurements by other experiments. This measurement provides the most precise result of the effective lifetime of the $$B^{0}$$ B 0 meson to date. </jats:p