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BACKGROUND: Incongruity between irregularly shaped vertebral endplates and the uniform surfaces of stock interbody fusion cages has been identified as contributing to cage subsidence, pseudarthrosis, and unpredictable alignment. Advances in manufacturing techniques have driven the development of personalized interbody cages (PICs) that can match individual endplate morphology and provide the exact shape and size needed to fill the disc space and achieve the planned correction. This study used computed tomography (CT) imaging to evaluate the implant-endplate contact area, fusion, subsidence, and achievement of planned alignment correction in patients receiving PIC devices. METHODS: This retrospective study included patients treated for adult spinal deformity at a single site and implanted with PIC devices at L4 to L5 or L5 to S1 for segmental stabilization and alignment correction, who received 1-year postoperative CT images as part of their standard of care. An evaluation using 3-dimensional thin-section scans was conducted. Implant-endplate contact and signs of fusion were assessed in each CT slice across both endplates. The degree of subsidence as well as measures of segmental and global lumbar alignment were also assessed. RESULTS: Fifteen patients were included in the study, with a mean age of 68.2 years. Follow-up ranged between 9 and 14 months. Twenty-six total lumbar levels were implanted; 20 with PIC devices via the anterior lumbar interbody fusion approach, 2 with stock cages via the anterior lumbar interbody fusion approach, and 4 with PIC devices via the transforaminal lumbar interbody fusion approach. CT analysis of PIC-implanted levels found an overall implant-endplate contact area ratio of 93.9%, a subsidence rate of 4.5%, a fusion rate of 100%, and satisfactory segmental and global lumbar correction compared with the preoperative plan. CONCLUSIONS: PIC implants can provide nearly complete contact with endplate surfaces regardless of the individual endplate morphology. Subsidence, fusion, and alignment assessments in this tomographic study illustrated results consistent with the benefits of a personalized interbody implant.

BACKGROUND: Literature supports the need for improved techniques to achieve spinopelvic alignment and reduce complication rates in patients with adult spinal deformity (ASD). Personalized interbody devices were developed to address this need and are under evaluation in the multicenter Clinical Outcome Measures in Personalized aprevo (circle R superscript) Spine Surgery (COMPASS (TM suprascript) registry. This report presents interim COMPASS pre- and postoperative sagittal alignment results and complication rates for a subcohort of COMPASS patients diagnosed and surgically treated for spinal deformity. METHODS: COMPASS is a postmarket observational registry of patients enrolled either before or after index surgery and then followed prospectively for 24 months. Sagittal alignment was assessed with SRS-Schwab modifiers for pelvic incidence minus lumbar lordosis, pelvic tilt, and T1 pelvic angle. Summed SRS-Schwab modifiers were utilized to assign overall deformity status as mild, moderate, or severe. Complications were extracted from patient medical records. RESULTS: The study included 67 patients from 9 centers. Preoperative severe deformity was observed in 66% of patients. Index surgeries included implantation of a median of 2 personalized interbody devices by anterior, lateral, or transforaminal approaches and with a median of 8 posteriorly instrumented levels. Overall postoperative sagittal alignment improved with a significant decrease in the mean sum of SRS-Schwab modifiers that correlated strongly to improvements in pelvic incidence minus lumbar lordosis. Among 44 patients with preoperative severe overall deformity, 16 improved to moderate and 9 to mild deformity. Complications occurred for 13 patients (19.4%), including 1 mechanical complication requiring revision 9 months after surgery and none related to personalized interbody devices. CONCLUSIONS: This study demonstrates that ASD patients whose treatment included personalized interbody devices can obtain favorable postoperative alignment status comparable to published results and with no complications related to the personalized interbody devices. CLINICAL RELEVANCE: This study contributes to growing evidence that personalized interbody devices contribute to improved sagittal alignment in ASD patients by directly adjusting the orientation of adjacent vertebra.

BACKGROUND: Lumbar lordosis distribution has become a pivotal factor in re-establishing the foundational alignment of the lumbar spine. This can directly influence overall sagittal alignment, leading to improved long-term outcomes for patients. Despite the wide availability of hyperlordotic stock cages intended to achieve optimal postoperative alignment, there is a lack of correlation between the lordotic shape of a cage and the resultant intervertebral alignment. Recently, personalized spine surgery has witnessed significant advancements, including 3D-printed personalized interbody implants, which are customized to the surgeons treatment and alignment goals. This study evaluates the reliability of 3D-printed patient-specific interbody implants to achieve the planned postoperative intervertebral alignment. METHODS: This is a retrospective study of 217 patients with spinal deformity or degenerative conditions. Patients were included if they received 3D-printed personalized interbody implants. The desired intervertebral lordosis (IVL) angle was prescribed into the device design for each personalized interbody (IVL goal). Standing postoperative radiographs were measured, and the IVL offset was calculated as IVL achieved minus IVL goal. RESULTS: In this patient population, 365 personalized interbodies were implanted, including 145 anterior lumbar interbody fusions (ALIFs), 99 lateral lumbar interbody fusions (LLIFs), and 121 transforaminal lumbar interbody fusions. Among the 365 treated levels, IVL offset was 1.1° ± 4.4° (mean ± SD). IVL was achieved within 5° of the plan in 299 levels (81.9%). IVL offset depended on the approach of the lumbar interbody fusion and was achieved within 5° for 85.9% of LLIF, 82.6% of transforaminal lumbar interbody fusions and 78.6% of ALIFs. Ten levels (2.7%) missed the planned IVL by >10°. ALIF and LLIF levels in which the plan was missed by more than 5° tended to be overcorrected. CONCLUSIONS: This study supports the use of 3D-printed personalized interbody implants to achieve planned sagittal intervertebral alignment. CLINICAL RELEVANCE: Personalized interbody implants can consistently achieve IVL goals and potentially impact foundational lumbar alignment.

BACKGROUND: An abnormal postoperative lordosis distribution index (LDI), which quantifies the ratio between the lordosis at L4 to S1 and the lordosis at L1 to S1, contributes to the development of adjacent segment disease and increased revision rates in patients undergoing short-segment lumbar intervertebral fusions. Incorporating preoperative spinopelvic parameters and LDI into the surgical plan for short-segment fusion is important for guiding alignment restoration and preserving normal preoperative alignment in unfused segments. This study examined changes in LDI, segmental lordosis, and lordosis of the unfused levels in patients treated with personalized interbody cage (PIC) implants. METHODS: This retrospective study evaluated radiographic measurements from 111 consecutively treated patients diagnosed with degenerative spinal conditions and treated with a short-segment fusion of L4 to L5, L5 to S1, or L4 to S1 using PIC implant(s) within 6 months of the fusion procedure. Comparisons of intervertebral lordosis for treated and untreated levels as well as LDI pre- and postoperatively were performed. RESULTS: In patients with a preoperative hypolordotic distribution (LDI < 50%), statistically significant increases were found in LDI postoperatively, approaching the normal LDI range (LDI 50%-80%). Likewise, patients with hyperlordotic distribution preoperatively (LDI > 80%) experienced a decrease in LDI postoperatively, trending toward the normal range, although the changes were not statistically significant. Intervertebral lordosis for the L5 to S1 level increased significantly following the placement of a PIC in the normal and hypolordotic LDI groups. Changes in intervertebral lordosis for L5 to S1 were not significant for patients with preoperative hyperlordotic LDI. Reciprocal changes in intervertebral lordosis at L1 to L4 were not observed in any groups. CONCLUSIONS: PIC implants may provide a benefit for patients, particularly those with hypolordotic distributions preoperatively. They have the potential to further improve patient outcomes by helping surgeons to achieve patient-specific lordosis goals, which may help to reduce the risk of adjacent segment disease and revisions in patients undergoing short-segment lumbar intervertebral fusions. CLINICAL RELEVANCE: Personalized implants can help surgeons achieve patient-specific alignment goals, potentially prevent adjacent segment disease, and reduce long-term reinterventions.

Several processes studied by the ATLAS experiment at the Large Hadron Collider produce low-momentum b-flavored hadrons in the final state. This paper describes the calibration of a dedicated tagging algorithm that identifies b-flavored hadrons outside of hadronic jets by reconstructing the soft secondary vertices originating from their decays. The calibration is based on a proton-proton collision dataset at a center-of-mass energy of 13 TeV corresponding to an integrated luminosity of 140  fb−1. Scale factors used to correct the algorithm’s performance in simulated events are extracted for the b-tagging efficiency and the mistag rate of the algorithm using a data sample enriched in tt¯ events. Several orthogonal measurement regions are defined, binned as a function of the multiplicities of soft secondary vertices and jets containing a b-flavored hadron in the event. The mistag rate scale factors are estimated separately for events with low and high average numbers of interactions per bunch crossing. The results, which are derived from events with low missing transverse momentum, are successfully validated in a phase space characterized by high missing transverse momentum and therefore are applicable to new physics searches carried out in either phase space regime. © 2024 CERN, for the ATLAS Collaboration 2024 CERN

STUDY DESIGN: Clinical case series. OBJECTIVE: To describe the cause, treatment and outcome of 6 cases of perioperative spinal cord injury (SCI) in high-risk adult deformity surgery. SETTING: Adult spinal deformity patients were enrolled in the multi-center Scoli-RISK-1 cohort study. METHODS: A total of 272 patients who underwent complex adult deformity surgery were enrolled in the prospective, multi-center Scoli-RISK-1 cohort study. Clinical follow up data were available up to a maximum of 2 years after index surgery. Cases of perioperative SCI were identified and an extensive case review was performed. RESULTS: Six individuals with SCI were identified from the Scoli-RISK-1 database (2.2%). Two cases occurred intraoperatively and four cases occurred postoperatively. The first case was an incomplete SCI due to a direct intraoperative insult and was treated postoperatively with Riluzole. The second SCI case was caused by a compression injury due to overcorrection of the deformity. Three cases of incomplete SCI occurred; one case of postoperative hematoma, one case of proximal junctional kyphosis (PJK) and one case of adjacent segment disc herniation. All cases of post-operative incomplete SCI were managed with revision decompression and resulted in excellent clinical recovery. One case of incomplete SCI resulted from infection and PJK. The patients treatment was complicated by a delay in revision and the patient suffered persistent neurological deficits up to six weeks following the onset of SCI. CONCLUSION: Despite the low incidence in high-risk adult deformity surgeries, perioperative SCI can result in devastating consequences. Thus, appropriate postoperative care, follow up and timely management of SCI are essential.

A search for the nonresonant production of Higgs boson pairs in the HH→bb¯τ+τ− channel is performed using 140  fb−1 of proton-proton collisions at a center-of-mass energy of 13 TeV recorded by the ATLAS detector at the CERN Large Hadron Collider. The analysis strategy is optimized to probe anomalous values of the Higgs boson self-coupling modifier κλ and of the quartic HHVV (V=W,Z) coupling modifier κ2V. No significant excess above the expected background from Standard Model processes is observed. An observed (expected) upper limit μHH

LUX-ZEPLIN (LZ) is a tonne-scale experiment searching for direct dark matter interactions and other rare events. It is located at the Sanford Underground Research Facility (SURF) in Lead, South Dakota, USA. The core of the LZ detector is a dual-phase xenon time projection chamber (TPC), designed with the primary goal of detecting Weakly Interacting Massive Particles (WIMPs) via their induced low energy nuclear recoils. Surrounding the TPC, two veto detectors immersed in an ultra-pure water tank enable reducing background events to enhance the discovery potential. Intricate calibration systems are purposely designed to precisely understand the responses of these three detector volumes to various types of particle interactions and to demonstrate LZ’s ability to discriminate between signals and backgrounds. In this paper, we present a comprehensive discussion of the key features, requirements, and performance of the LZ calibration systems, which play a crucial role in enabling LZ’s WIMP-search and its broad science program. The thorough description of these calibration systems, with an emphasis on their novel aspects, is valuable for future calibration efforts in direct dark matter and other rare-event search experiments.

Abstract: The identification of top quark decays where the top quark has a large momentum transverse to the beam axis, known as top tagging, is a crucial component in many measurements of Standard Model processes and searches for beyond the Standard Model physics at the Large Hadron Collider.Machine learning techniques have improved the performance of top tagging algorithms, but the size of the systematic uncertainties for all proposed algorithms has not been systematically studied.This paper presents the performance of several machine learning based top tagging algorithms on a dataset constructed from simulated proton-proton collision events measured with the ATLAS detector at √ s = 13 TeV.The systematic uncertainties associated with these algorithms are estimated through an approximate procedure that is not meant to be used in a physics analysis, but is appropriate for the level of precision required for this study.The most performant algorithms are found to have the largest uncertainties, motivating the development of methods to reduce these uncertainties without compromising performance.To enable such efforts in the wider scientific community, the datasets used in this paper are made publicly available.

A search is performed for localized excesses in the low-mass dijet invariant mass distribution, targeting a hypothetical new particle decaying into two jets and produced in association with either a high transverse momentum photon or a jet. The search uses the full Run 2 data sample from LHC proton-proton collisions collected by the ATLAS experiment at a center-of-mass energy of 13 TeV during 2015–2018. Two variants of the search are presented for each type of initial-state radiation: one that makes no jet flavor requirements and one that requires both of the jets to have been identified as containing b-hadrons. No excess is observed relative to the Standard Model prediction, and the data are used to set upper limits on the production cross section for a benchmark Z′ model and, separately, for generic, beyond the Standard Model scenarios which might produce a Gaussian-shaped contribution to dijet invariant mass distributions. The results extend the current constraints on dijet resonances to the mass range between 200 and 650 GeV. © 2024 CERN, for the ATLAS Collaboration 2024 CERN

A measurement of the Standard Model Higgs boson produced in association with a W or Z boson and decaying into a pair of τ-leptons is presented. This search is based on proton-proton collision data collected at s=13 TeV by the ATLAS experiment at the LHC corresponding to an integrated luminosity of 140 fb−1. For the Higgs boson candidate, only final states with at least one τ-lepton decaying hadronically (τ→hadrons+ντ) are considered. For the vector bosons, only leptonic decay channels are considered: Z→ℓℓ and W→ℓνℓ, with ℓ=e,μ. An excess of events over the expected background is found with an observed (expected) significance of 4.2 (3.6) standard deviations, providing evidence of the Higgs boson produced in association with a vector boson and decaying into a pair of τ-leptons. The ratio of the measured cross-section to the Standard Model prediction is μVHττ=1.28−0.29+0.30(stat.)−0.21+0.25(syst.). This result represents the most accurate measurement of the VH(ττ) process achieved to date.

This paper reports cross-section measurements of ZZ production in pp collisions at s=13.6TeV at the Large Hadron Collider. The data were collected by the ATLAS detector in 2022, and correspond to an integrated luminosity of 29 fb−1. Events in the ZZ→4ℓ (ℓ=e, μ) final states are selected and used to measure the inclusive and differential cross-sections in a fiducial region defined close to the analysis selections. The inclusive cross-section is further extrapolated to the total phase space with a requirement of 66

Searches for exclusive decays of the Higgs boson into D⁎γ and of the Z boson into D0γ and Ks0γ can probe flavour-violating Higgs boson and Z boson couplings to light quarks. Searches for these decays are performed with a pp collision data sample corresponding to an integrated luminosity of 136.3 fb−1 collected at s=13TeV between 2016–2018 with the ATLAS detector at the CERN Large Hadron Collider. In the D⁎γ and D0γ channels, the observed (expected) 95% confidence-level upper limits on the respective branching fractions are B(H→D⁎γ)

Abstract: A search is presented for flavour-changing neutral-current interactions involving the top quark, the Higgs boson and an up-type quark ($$q=u,c$$ q = u , c ) with the ATLAS detector at the Large Hadron Collider. The analysis considers leptonic decays of the top quark along with Higgs boson decays into two $$W$$ W bosons, two $$Z$$ Z bosons or a $$\tau ^{+}\tau ^{-}$$ τ + τ - pair. It focuses on final states containing either two leptons (electrons or muons) of the same charge or three leptons. The considered processes are $$t\bar{t}$$ t t ¯ and Ht production. For the $$t\bar{t}$$ t t ¯ production, one top quark decays via $$t\rightarrow Hq$$ t → H q . The proton–proton collision data set analysed amounts to $$({140}\,{\hbox {fb}^{-1}})$$ ( 140 fb - 1 ) at $$(\sqrt{s}={13}\,\hbox {TeV})$$ ( s = 13 TeV ) . No significant excess beyond Standard Model expectations is observed and upper limits are set on the $$t\rightarrow Hq$$ t → H q branching ratios at 95 % confidence level, amounting to observed (expected) limits of $$\mathcal {B}(t\rightarrow Hu)

Abstract: Presented is the search for anomalous Higgs boson decays into two axion-like particles (ALPs) using the full Run 2 data set of $$140\,\text {fb}^{-1}$$ 140 fb - 1 of proton-proton collisions at a centre-of-mass energy of $$13\,\text {TeV}$$ 13 TeV recorded by the ATLAS experiment. The ALPs are assumed to decay into two photons, providing sensitivity to recently proposed models that could explain the $$(g-2)_\mu $$ ( g - 2 ) μ discrepancy. This analysis covers an ALP mass range from 100 to $$62\,\text {GeV}$$ 62 GeV and ALP-photon couplings in the range $$10^{-7}\,\text {TeV}^{-1} 10 - 7 TeV - 1 < C a γ γ / Λ < 1 TeV - 1 , and therefore includes signatures with significantly displaced vertices and highly collinear photons. No significant excess of events above the Standard Model background is observed. Upper limits at 95% confidence level are placed on the branching ratio of the Higgs boson to two ALPs in the four-photon final state, and are in the range of $$ 10^{-5}$$ 10 - 5 to $$3\times 10^{-2}$$ 3 × 10 - 2 , depending on the hypothesized ALP mass and ALP-photon coupling strength.

A search for charged-lepton-flavor violating μτqt (q=u, c) interactions is presented, considering both top-quark production and decay. The data analyzed correspond to 140  fb−1 of proton-proton collisions at a center-of-mass energy of s=13  TeV recorded with the ATLAS detector at the Large Hadron Collider. The analysis targets events containing two muons with the same electric charge, a hadronically decaying τ-lepton and at least one jet, with exactly one b-tagged jet, produced by a μτqt interaction. Agreement with the Standard Model expectation within 1.6 standard deviations is observed, and limits are set at the 95% confidence level (CL) on the charged-lepton-flavor violation branching ratio of B(t→μτq)

Abstract: A search is reported for long-lived dark photons with masses between 0.1 GeV and 15 GeV, from exotic decays of Higgs bosons produced via vector-boson-fusion. Events that contain displaced collimated Standard Model fermions reconstructed in the calorimeter or muon spectrometer are probed. This search uses the full LHC Run 2 (2015–2018) data sample collected in proton–proton collisions at $$\sqrt{s}=13$$ s = 13 TeV, corresponding to an integrated luminosity of 139 $$fb^{-1}$$ f b - 1 . Dominant backgrounds from Standard Model processes and non-collision sources are estimated using data-driven techniques. The observed event yields in the signal regions are consistent with the expected background. Upper limits on the Higgs boson to dark photon branching fraction are reported as a function of the dark photon mean proper decay length or of the dark photon mass and the coupling between the Standard Model and the potential dark sector. This search is combined with previous ATLAS searches obtained in the gluon–gluon fusion and WH production modes. A branching fraction above 10% is excluded at 95% CL for a 125 GeV Higgs boson decaying into two dark photons for dark photon mean proper decay lengths between 173 and 1296 mm and mass of 10 GeV.

Statistical combinations of searches for charginos and neutralinos using various decay channels are performed using 139  fb^{-1} of pp collision data at sqrt[s]=13  TeV with the ATLAS detector at the Large Hadron Collider. Searches targeting pure-wino chargino pair production, pure-wino chargino-neutralino production, or Higgsino production decaying via standard model W, Z, or h bosons are combined to extend the mass reach to the produced supersymmetric particles by 30-100 GeV. The depth of the sensitivity of the original searches is also improved by the combinations, lowering the 95% C.L. cross-section upper limits by 15%-40%.

Fiducial and total W± and Z boson cross sections, their ratios and the ratio of top-antitop-quark pair and W-boson fiducial cross sections are measured in proton–proton collisions at a centre-of-mass energy of s=13.6 TeV, corresponding to an integrated luminosity of 29 fb−1 of data collected in 2022 by the ATLAS experiment at the Large Hadron Collider. The measured fiducial cross-section values for W+→ℓ+ν, W−→ℓ−ν¯, and Z→ℓ+ℓ− (ℓ=e or μ) boson productions are 4250±150 pb, 3310±120 pb, and 744±20 pb, respectively, where the uncertainty is the total uncertainty, including that arising from the luminosity of about 2.2%. The measurements are in agreement with Standard-Model predictions calculated at next-to-next-to-leading-order in αs, next-to-next-to-leading logarithmic accuracy and next-to-leading-order electroweak accuracy.

A search is presented for the pair-production of heavy vector-like quarks in the lepton+jets final state using 140 fb−1 of proton–proton collisions at s=13 TeV collected with the ATLAS detector. The search is optimised for vector-like top-quarks (T) that decay into a W boson and a b-quark, with one W boson decaying leptonically and the other hadronically. Other vector-like quark flavours and decay modes are also considered. Events are selected with one high transverse-momentum electron or muon, large missing transverse momentum, a large-radius jet identified as a W boson, and multiple small-radius jets, at least one of which is b-tagged. Vector-like T-quarks with 100% branching ratio to Wb are excluded at 95% CL for masses below 1700 GeV. These limits are also applied to vector-like Y-quarks, which decay exclusively into a W boson and a b-quark. Isospin singlets with B(T→Wb:Ht:Zt)=1/2:1/4:1/4 are excluded for masses below 1360 GeV.

A measurement of the invisible width of the Z boson using events with jets and missing transverse momentum is presented using 37 fb−1 of 13 TeV proton–proton data collected by the ATLAS detector in 2015 and 2016. The ratio of Z→inv to Z→ℓℓ events, where inv refers to non-detected particles and ℓ is either an electron or a muon, is measured and corrected for detector effects. Events with at least one energetic central jet with pT≥110 GeV are selected for both the Z→inv and Z→ℓℓ final states to obtain a similar phase space in the ratio. The invisible width is measured to be 506±2(stat.)±12(syst.) MeV and is the single most precise recoil-based measurement. The result is in agreement with the most precise determination from LEP and the Standard Model prediction based on three neutrino generations.

A statistical combination of various searches for pair-produced leptoquarks is presented, using the full LHC Run 2 (2015–2018) data set of 139 fb−1 collected with the ATLAS detector from proton–proton collisions at a centre-of-mass energy of s=13 TeV. All possible decays of the leptoquarks into quarks of the third generation and charged or neutral leptons of any generation are investigated. Since no significant deviations from the Standard Model expectation are observed in any of the individual analyses, combined exclusion limits are set on the production cross-sections for scalar and vector leptoquarks. The resulting lower bounds on leptoquark masses exceed those from the individual analyses by up to 100 GeV, depending on the signal hypothesis.

The observation of the electroweak production of single-top-quarks is made using 255 pb−1 of proton-proton collision data recorded at s=5.02 TeV with the ATLAS detector at the Large Hadron Collider. An event selection is used to identify single-top-quark candidates arising from t-channel production with the top quark decaying semi-leptonically. Events passing the selection are then used to measure the inclusive cross-section for the combined production of single-top-quarks and antiquarks, σ(tq+t¯q), and the ratio Rt between these two. They are measured to be σ(tq+t¯q)=27.1−4.1+4.4(stat.)−3.7+4.4(syst.) pb and Rt=2.73−0.82+1.43(stat.)−0.29+1.01(syst.). The individual single-top-quark (tq) and single-top-antiquark (t¯q) production cross-sections are measured to be σ(tq)=19.8−3.1+3.9(stat.)−2.2+2.9(syst.) pb and σ(t¯q)=7.3−2.1+3.2(stat.)−1.5+2.8(syst.) pb. All measurements are in good agreement with the Standard Model predictions.

A combination of searches for a new resonance decaying into a Higgs boson pair is presented, using up to 139  fb^{-1} of pp collision data at sqrt[s]=13  TeV recorded with the ATLAS detector at the LHC. The combination includes searches performed in three decay channels: bb[over ¯]bb[over ¯], bb[over ¯]τ^{+}τ^{-}, and bb[over ¯]γγ. No excess above the expected Standard Model background is observed and upper limits are set at the 95% confidence level on the production cross section of Higgs boson pairs originating from the decay of a narrow scalar resonance with mass in the range 251 GeV-5 TeV. The observed (expected) limits are in the range 0.96-600 fb (1.2-390 fb). The limits are interpreted in the type-I two-Higgs-doublet model and the minimal supersymmetric standard model, and constrain parameter space not previously excluded by other searches.

STUDY DESIGN: Retrospective review of prospective database. OBJECTIVES: Vertebral pelvic angles (VPAs) account for complexity in spine shape by assessing the relative position of each vertebra with regard to the pelvis. This study uses VPAs to investigate the shape of the fused spine after T10-pelvis fusion, in patients with adult spinal deformity (ASD), and then explores its association with proximal junctional kyphosis (PJK). METHODS: Included patients had radiographic evidence of ASD and underwent T10-pelvis realignment. VPAs were used to construct a virtual shape of the post-operative spine. VPA-predicted and actual shapes were then compared between patients with and without PJK. Logistic regression was used to identify components of the VPA-based model that were independent predictors of PJK occurrence and post-operative shape. RESULTS: 287 patients were included. VPA-predicted shape was representative of the true post-operative contour, with a mean point-to-point error of 1.6-2.9% of the T10-S1 spine length. At 6-weeks follow-up, 102 patients (35.5%) developed PJK. Comparison of the true post-operative shapes demonstrated that PJK patients had more posteriorly translated vertebrae from L3 to T7 (P < .001). Logistic regression demonstrated that L3PA (P = .047) and T11PA (P < .001) were the best independent predictors of PJK and were, in conjunction with pelvic incidence, sufficient to reproduce the actual spinal contour (error

Searches for dark matter with liquid xenon time projection chamber experiments have traditionally focused on the region of the parameter space that is characteristic of weakly interacting massive particles, ranging from a few GeV/c2 to a few TeV/c2. Models of dark matter with a mass much heavier than this are well motivated by early production mechanisms different from the standard thermal freeze-out, but they have generally been less explored experimentally. In this work, we present a reanalysis of the first science run of the LZ experiment, with an exposure of 0.9 tonne×yr, to search for ultraheavy particle dark matter. The signal topology consists of multiple energy deposits in the active region of the detector forming a straight line, from which the velocity of the incoming particle can be reconstructed on an event-by-event basis. Zero events with this topology were observed after applying the data selection calibrated on a simulated sample of signal-like events. New experimental constraints are derived, which rule out previously unexplored regions of the dark matter parameter space of spin-independent interactions beyond a mass of 1017 GeV/c2.

Internationally, the United States (U.S.) cites the highest cost burden of low back pain (LBP). The cost continues to rise, faster than the rate of inflation and overall growth of health expenditures. We performed a comprehensive literature review of peer-reviewed and non- peer-reviewed literature from PubMed, Scopus, and Google Scholar for contemporary data on prevalence, cost, and projected future costs. Policymakers in the U.S. have long attempted to address the high-cost burden of LBP through limiting low-value services and early imaging. Despite these efforts, costs (~$40 billion; ~$2,000/patient/yr) continue to rise with increasing rates of unindicated imaging, high rates of surgery, and subsequent revision surgery without proper trial of non-pharmacologic measures and no corresponding reduction in LBP prevalence. Globally, the overall prevalence of LBP continues to rise largely secondary to a growing aging population. Cost containment methods should focus on careful and comprehensive clinical assessment of patients to better understand when more resource-intensive interventions are indicated.

The ATLAS trigger system is a crucial component of the ATLAS experiment at the LHC. It is responsible for selecting events in line with the ATLAS physics programme. This paper presents an overview of the changes to the trigger and data acquisition system during the second long shutdown of the LHC, and shows the performance of the trigger system and its components in the proton-proton collisions during the 2022 commissioning period as well as its expected performance in proton-proton and heavy-ion collisions for the remainder of the third LHC data-taking period (2022–2025).

Measurements of the substructure of top-quark jets are presented, using Formula Presented of 13 TeV Formula Presented collision data recorded with the ATLAS detector at the LHC. Top-quark jets reconstructed with the anti-Formula Presented algorithm with a radius parameter Formula Presented are selected in top-quark pair (Formula Presented) events where one top quark decays semileptonically and the other hadronically, or where both top quarks decay hadronically. The top-quark jets are required to have transverse momentum Formula Presented, yielding large samples of data events with jet Formula Presented values between 350 and 600 GeV. One- and two-dimensional differential cross sections for eight substructure variables, defined using only the charged components of the jets, are measured in a particle-level phase space by correcting for the smearing and acceptance effects induced by the detector. The differential cross sections are compared with the predictions of several Monte Carlo simulations in which top-quark pair-production quantum chromodynamic matrix-element calculations at next-to-leading-order precision in the strong coupling constant Formula Presented are passed to leading-order parton shower and hadronization generators. The Monte Carlo predictions for measures of the broadness, and also the two-body structure, of the top-quark jets are found to be in good agreement with the measurements, while variables sensitive to the three-body structure of the top-quark jets exhibit some tension with the measured distributions.

A search for the single production of a vectorlike top partner (Formula Presented) with mass greater than 1 TeV decaying into a Formula Presented boson and a top quark is presented, using the full Run 2 dataset corresponding to Formula Presented of Formula Presented collisions at Formula Presented, collected in 2015-2018 with the ATLAS detector at the Large Hadron Collider. The targeted final state is characterized by the presence of a pair of electrons or muons with opposite-sign charges which form a Formula Presented-boson candidate, as well as by the presence of Formula Presented-tagged jets and forward jets. Events with exactly two or at least three leptons are categorized into two independently optimized analysis channels. No significant excess above the background expectation is observed and the results from the two channels are statistically combined to set exclusion limits at 95% confidence level on the masses and couplings of Formula Presented. The results are interpreted in several benchmark scenarios to set limits on the mass and universal coupling strength (Formula Presented) of the vectorlike quark. For singlet Formula Presented quarks, Formula Presented values between 0.22 and 0.64 are excluded for masses between 1000 and 1975 GeV. For Formula Presented quarks in the doublet scenario, where the production cross section is much lower, Formula Presented values between 0.54 and 0.88 are excluded for masses between 1000 and 1425 GeV.

This paper presents a search for pair production of higgsinos, the supersymmetric partners of the Higgs bosons, in scenarios with gauge-mediated supersymmetry breaking. Each higgsino is assumed to decay into a Higgs boson and a nearly massless gravitino. The search targets events where each Higgs boson decays into Formula Presented, leading to a reconstructed final state with at least three energetic Formula Presented-jets and missing transverse momentum. Two complementary analysis channels are used, with each channel specifically targeting either low or high values of the higgsino mass. The low-mass (high-mass) channel exploits Formula Presented of Formula Presented data collected by the ATLAS detector during Run 2 of the Large Hadron Collider. No significant excess above the Standard Model prediction is found. At 95% confidence level, masses between 130 GeV and 940 GeV are excluded for higgsinos decaying exclusively into Higgs bosons and gravitinos. Exclusion limits as a function of the higgsino decay branching ratio to a Higgs boson are also reported.

Inelastic beam-gas collisions at the Large Hadron Collider (LHC), within a few hundred metres of the ATLAS experiment, are known to give the dominant contribution to beam backgrounds. These are monitored by ATLAS with a dedicated Beam Conditions Monitor (BCM) and with the rate of fake jets in the calorimeters. These two methods are complementary since the BCM probes backgrounds just around the beam pipe while fake jets are observed at radii of up to several metres. In order to quantify the correlation between the residual gas density in the LHC beam vacuum and the experimental backgrounds recorded by ATLAS, several dedicated tests were performed during LHC Run 2. Local pressure bumps, with a gas density several orders of magnitude higher than during normal operation, were introduced at different locations. The changes of beam-related backgrounds, seen in ATLAS, are correlated with the local pressure variation. In addition the rates of beam-gas events are estimated from the pressure measurements and pressure bump profiles obtained from calculations. Using these rates, the efficiency of the ATLAS beam background monitors to detect beam-gas events is derived as a function of distance from the interaction point. These efficiencies and characteristic distributions of fake jets from the beam backgrounds are found to be in good agreement with results of beam-gas simulations performed with the Fluka Monte Carlo programme.