Background: Surgery is the main modality of cure for solid cancers and was prioritised to continue during COVID-19 outbreaks. This study aimed to identify immediate areas for system strengthening by comparing the delivery of elective cancer surgery during the COVID-19 pandemic in periods of lockdown versus light restriction. Methods: This international, prospective, cohort study enrolled 20 006 adult (≥18 years) patients from 466 hospitals in 61 countries with 15 cancer types, who had a decision for curative surgery during the COVID-19 pandemic and were followed up until the point of surgery or cessation of follow-up (Aug 31, 2020). Average national Oxford COVID-19 Stringency Index scores were calculated to define the government response to COVID-19 for each patient for the period they awaited surgery, and classified into light restrictions (index 60). The primary outcome was the non-operation rate (defined as the proportion of patients who did not undergo planned surgery). Cox proportional-hazards regression models were used to explore the associations between lockdowns and non-operation. Intervals from diagnosis to surgery were compared across COVID-19 government response index groups. This study was registered at ClinicalTrials.gov, NCT04384926. Findings: Of eligible patients awaiting surgery, 2003 (10·0%) of 20 006 did not receive surgery after a median follow-up of 23 weeks (IQR 16-30), all of whom had a COVID-19-related reason given for non-operation. Light restrictions were associated with a 0·6% non-operation rate (26 of 4521), moderate lockdowns with a 5·5% rate (201 of 3646; adjusted hazard ratio [HR] 0·81, 95% CI 0·77-0·84; p<0·0001), and full lockdowns with a 15·0% rate (1775 of 11 827; HR 0·51, 0·50-0·53; p<0·0001). In sensitivity analyses, including adjustment for SARS-CoV-2 case notification rates, moderate lockdowns (HR 0·84, 95% CI 0·80-0·88; p<0·001), and full lockdowns (0·57, 0·54-0·60; p<0·001), remained independently associated with non-operation. Surgery beyond 12 weeks from diagnosis in patients without neoadjuvant therapy increased during lockdowns (374 [9·1%] of 4521 in light restrictions, 317 [10·4%] of 3646 in moderate lockdowns, 2001 [23·8%] of 11 827 in full lockdowns), although there were no differences in resectability rates observed with longer delays. Interpretation: Cancer surgery systems worldwide were fragile to lockdowns, with one in seven patients who were in regions with full lockdowns not undergoing planned surgery and experiencing longer preoperative delays. Although short-term oncological outcomes were not compromised in those selected for surgery, delays and non-operations might lead to long-term reductions in survival. During current and future periods of societal restriction, the resilience of elective surgery systems requires strengthening, which might include protected elective surgical pathways and long-term investment in surge capacity for acute care during public health emergencies to protect elective staff and services.
BMWFW (Austria) ; FWF (Austria) ; FNRS (Belgium) ; FWO (Belgium) ; Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) ; Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) ; Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ) ; FAPERGS (Brazil) ; Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) ; MES (Bulgaria) ; MoST (China) ; NSFC (China) ; COLCIENCIAS (Colombia) ; CSF (Croatia) ; SENESCYT (Ecuador) ; MoER (Estonia) ; ERDF (Estonia) ; Academy of Finland (Finland) ; MEC (Finland) ; CEA (France) ; CNRS/IN2P3 (France) ; BMBF (Germany) ; DFG (Germany) ; HGF (Germany) ; GSRT (Greece) ; NKFIA (Hungary) ; DAE (India) ; DST (India) ; IPM (Iran) ; SFI (Ireland) ; INFN (Italy) ; NRF (Republic of Korea) ; MOE (Malaysia) ; UM (Malaysia) ; BUAP (Mexico) ; CONACYT (Mexico) ; UASLP-FAI (Mexico) ; FCT (Portugal) ; JINR (Dubna) ; RosAtom (Russia) ; RFBR (Russia) ; MESTD (Serbia) ; SEIDI (Spain) ; FEDER (Spain) ; MOSTR (Sri Lanka) ; Swiss Funding Agencies (Switzerland) ; NSTDA (Thailand) ; TUBITAK (Turkey) ; TAEK (Turkey) ; NASU (Ukraine) ; DOE (U.S.A.) ; NSF (U.S.A.) ; Marie-Curie program (European Union) ; European Research Council (European Union) ; Horizon 2020 Grant (European Union) ; Leventis Foundation ; A. P. Sloan Foundation ; Alexander von Humboldt Foundation ; Belgian Federal Science Policy Office ; Fonds pour la Formation a la Recherche dans l'Industrie et dans l'Agriculture (FRIA-Belgium) ; Agentschap voor Innovatie door Wetenschap en Technologie (IWT-Belgium) ; FWO (Belgium) under the Excellence of Science - EOS ; Ministry of Education, Youth and Sports (MEYS) of the Czech Republic ; Janos Bolyai Research Scholarship of the Hungarian Academy of Sciences (Hungary) ; Council of Science and Industrial Research, India ; HOMING PLUS program of the Foundation for Polish Science ; European Union, Regional Development Fund ; Sonata-bis ; National Priorities Research Program by Qatar National Research Fund ; Programa Severo Ochoa del Principado de Asturias ; Aristeia program - EU-ESF ; Greek NSRF ; Rachadapisek Sompot Fund for Postdoctoral Fellowship, Chulalongkorn University (Thailand) ; Welch Foundation ; Weston Havens Foundation (U.S.A.) ; Hellenic Foundation for Research and Innovation, HFRI ; Fondazione Ing. Aldo Gini ; CERN ; CAS (China) ; MSES (Croatia) ; RPF (Cyprus) ; ERC IUT (Estonia) ; HIP (Finland) ; MSIP (Republic of Korea) ; LAS (Lithuania) ; CINVESTAV (Mexico) ; LNS (Mexico) ; SEP (Mexico) ; MOS (Montenegro) ; MBIE (New Zealand) ; PAEC (Pakistan) ; MSHE (Poland) ; NSC (Poland) ; MON (Russia) ; RAS (Russia) ; NRC KI (Russia) ; CPAN (Spain) ; PCTI (Spain) ; MST (Taipei) ; ThEPCenter (Thailand) ; IPST (Thailand) ; STAR (Thailand) ; STFC (United Kingdom) ; SFFR (Ukraine) ; F.R.S.-FNRS (Belgium) ; Lendulet (Momentum) Programme (Hungary) ; New National Excellence Program UNKP (Hungary) ; National Science Center (Poland) ; Mobility Plus program of the Ministry of Science and Higher Education ; Programa Estatal de Fomento de la Investigacion Cientifica y Tecnica de Excelencia Maria de Maeztu ; Thalis program - EU-ESF ; Chulalongkorn Academic into Its 2nd Century Project Advancement Project (Thailand) ; NKFIA (Hungary): 123842 ; NKFIA (Hungary): 123959 ; NKFIA (Hungary): 124845 ; NKFIA (Hungary): 124850 ; NKFIA (Hungary): 125105 ; Horizon 2020 Grant (European Union): 675440 ; FWO (Belgium) under the Excellence of Science - EOS: 30820817 ; Sonata-bis: 2012/07/E/ST2/01406 ; National Priorities Research Program by Qatar National Research Fund: MDM-2015-0509 ; Welch Foundation: C-1845 ; National Science Center (Poland): Harmonia 2014/14/M/ST2/00428 ; National Science Center (Poland): Opus 2014/13/B/ST2/02543 ; National Science Center (Poland): 2014/15/B/ST2/03998 ; National Science Center (Poland): 2015/19/B/ST2/02861 ; Programa Estatal de Fomento de la Investigacion Cientifica y Tecnica de Excelencia Maria de Maeztu: MDM-2015-0509 ; The structure of the CMS inner tracking system has been studied using nuclear interactions of hadrons striking its material. Data from proton-proton collisions at a center-of-mass energy of 13 TeV recorded in 2015 at the LHC are used to reconstruct millions of secondary vertices from these nuclear interactions. Precise positions of the beam pipe and the inner tracking system elements, such as the pixel detector support tube, and barrel pixel detector inner shield and support rails, are determined using these vertices. These measurements are important for detector simulations, detector upgrades, and to identify any changes in the positions of inactive elements.
ANPCyT, Argentina ; YerPhI, Armenia ; ARC, Australia ; BMWFW, Austria ; FWF, Austria ; ANAS, Azerbaijan ; SSTC, Belarus ; Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) ; Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) ; NSERC, Canada ; NRC, Canada ; CFI, Canada ; CERN ; CONICYT, Chile ; CAS, China ; MOST, China ; NSFC, China ; COLCIENCIAS, Colombia ; MSMT CR, Czech Republic ; MPO CR, Czech Republic ; VSC CR, Czech Republic ; DNRF, Denmark ; DNSRC, Denmark ; IN2P3-CNRS, CEA-DRF/IRFU, France ; SRNSFG, Georgia ; BMBF, Germany ; HGF, Germany ; MPG, Germany ; GSRT, Greece ; RGC, Hong Kong SAR, China ; ISF, Israel ; Benoziyo Center, Israel ; INFN, Italy ; MEXT, Japan ; JSPS, Japan ; CNRST, Morocco ; NWO, Netherlands ; RCN, Norway ; MNiSW, Poland ; NCN, Poland ; FCT, Portugal ; MNE/IFA, Romania ; MES of Russia, Russian Federation ; NRC KI, Russian Federation ; JINR ; MESTD, Serbia ; MSSR, Slovakia ; ARRS, Slovenia ; MIZS, Slovenia ; DST/NRF, South Africa ; MINECO, Spain ; SRC, Sweden ; Wallenberg Foundation, Sweden ; SERI, Switzerland ; SNSF, Switzerland ; Canton of Bern, Switzerland ; MOST, Taiwan ; TAEK, Turkey ; STFC, United Kingdom ; DOE, United States of America ; NSF, United States of America ; BCKDF, Canada ; CANARIE, Canada ; CRC, Canada ; Compute Canada, Canada ; COST, European Union ; ERC, European Union ; ERDF, European Union ; Horizon 2020, European Union ; Marie Sk lodowska-Curie Actions, European Union ; Investissements d' Avenir Labex and Idex, ANR, France ; DFG, Germany ; AvH Foundation, Germany ; Greek NSRF, Greece ; BSF-NSF, Israel ; GIF, Israel ; CERCA Programme Generalitat de Catalunya, Spain ; Royal Society, United Kingdom ; Leverhulme Trust, United Kingdom ; BMBWF (Austria) ; FWF (Austria) ; FNRS (Belgium) ; FWO (Belgium) ; Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) ; Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ) ; FAPERGS (Brazil) ; MES (Bulgaria) ; CAS (China) ; MoST (China) ; NSFC (China) ; COLCIENCIAS (Colombia) ; MSES (Croatia) ; CSF (Croatia) ; RPF (Cyprus) ; SENESCYT (Ecuador) ; MoER (Estonia) ; ERC IUT (Estonia) ; ERDF (Estonia) ; Academy of Finland (Finland) ; MEC (Finland) ; HIP (Finland) ; CEA (France) ; CNRS/IN2P3 (France) ; BMBF (Germany) ; DFG (Germany) ; HGF (Germany) ; GSRT (Greece) ; NKFIA (Hungary) ; DAE (India) ; DST (India) ; IPM (Iran) ; SFI (Ireland) ; INFN (Italy) ; MSIP (Republic of Korea) ; NRF (Republic of Korea) ; MES (Latvia) ; LAS (Lithuania) ; MOE (Malaysia) ; UM (Malaysia) ; BUAP (Mexico) ; CINVESTAV (Mexico) ; CONACYT (Mexico) ; LNS (Mexico) ; SEP (Mexico) ; UASLP-FAI (Mexico) ; MOS (Montenegro) ; MBIE (New Zealand) ; PAEC (Pakistan) ; MSHE (Poland) ; NSC (Poland) ; FCT (Portugal) ; JINR (Dubna) ; MON (Russia) ; RosAtom (Russia) ; RAS (Russia) ; RFBR (Russia) ; NRC KI (Russia) ; MESTD (Serbia) ; SEIDI (Spain) ; CPAN (Spain) ; PCTI (Spain) ; FEDER (Spain) ; MOSTR (Sri Lanka) ; MST (Taipei) ; ThEPCenter (Thailand) ; IPST (Thailand) ; STAR (Thailand) ; NSTDA (Thailand) ; TAEK (Turkey) ; NASU (Ukraine) ; SFFR (Ukraine) ; STFC (United Kingdom ; DOE (U.S.A.) ; NSF (U.S.A.) ; Marie-Curie programme ; Horizon 2020 Grant (European Union) ; Leventis Foundation ; A.P. Sloan Foundation ; Alexander von Humboldt Foundation ; Belgian Federal Science Policy Office ; Fonds pour la Formation a la Recherche dans l'Industrie et dans l'Agriculture (FRIA-Belgium) ; Agentschap voor Innovatie door Wetenschap en Technologie (IWT-Belgium) ; F.R.S.-FNRS (Belgium) ; Beijing Municipal Science & Technology Commission ; Ministry of Education, Youth and Sports (MEYS) of the Czech Republic ; Hungarian Academy of Sciences (Hungary) ; New National Excellence Program UNKP (Hungary) ; Council of Science and Industrial Research, India ; HOMING PLUS programme of the Foundation for Polish Science ; European Union, Regional Development Fund ; Mobility Plus programme of the Ministry of Science and Higher Education ; National Science Center (Poland) ; National Priorities Research Program by Qatar National Research Fund ; Programa Estatal de Fomento de la Investigacion Cientfica y Tecnica de Excelencia Maria de Maeztu ; Programa Severo Ochoa del Principado de Asturias ; EU-ESF ; Greek NSRF ; Rachadapisek Sompot Fund for Postdoctoral Fellowship, Chulalongkorn University (Thailand) ; Chulalongkorn Academic into Its 2nd Century Project Advancement Project (Thailand) ; Welch Foundation ; Weston Havens Foundation (U.S.A.) ; Canton of Geneva, Switzerland ; Herakleitos programme ; Thales programme ; Aristeia programme ; European Research Council (European Union) ; Horizon 2020 Grant (European Union): 675440 ; FWO (Belgium): 30820817 ; Beijing Municipal Science & Technology Commission: Z181100004218003 ; NKFIA (Hungary): 123842 ; NKFIA (Hungary): 123959 ; NKFIA (Hungary): 124845 ; NKFIA (Hungary): 124850 ; NKFIA (Hungary): 125105 ; National Science Center (Poland): Harmonia 2014/14/M/ST2/00428 ; National Science Center (Poland): Opus 2014/13/B/ST2/02543 ; National Science Center (Poland): 2014/15/B/ST2/03998 ; National Science Center (Poland): 2015/19/B/ST2/02861 ; National Science Center (Poland): Sonata-bis 2012/07/E/ST2/01406 ; Programa Estatal de Fomento de la Investigacion Cientfica y Tecnica de Excelencia Maria de Maeztu: MDM-2015-0509 ; Welch Foundation: C-1845 ; This paper presents the combinations of single-top-quark production cross-section measurements by the ATLAS and CMS Collaborations, using data from LHC proton-proton collisions at = 7 and 8 TeV corresponding to integrated luminosities of 1.17 to 5.1 fb(-1) at = 7 TeV and 12.2 to 20.3 fb(-1) at = 8 TeV. These combinations are performed per centre-of-mass energy and for each production mode: t-channel, tW, and s-channel. The combined t-channel cross-sections are 67.5 +/- 5.7 pb and 87.7 +/- 5.8 pb at = 7 and 8 TeV respectively. The combined tW cross-sections are 16.3 +/- 4.1 pb and 23.1 +/- 3.6 pb at = 7 and 8 TeV respectively. For the s-channel cross-section, the combination yields 4.9 +/- 1.4 pb at = 8 TeV. The square of the magnitude of the CKM matrix element V-tb multiplied by a form factor f(LV) is determined for each production mode and centre-of-mass energy, using the ratio of the measured cross-section to its theoretical prediction. It is assumed that the top-quark-related CKM matrix elements obey the relation |V-td|, |V-ts| « |V-tb|. All the |f(LV)V(tb)|(2) determinations, extracted from individual ratios at = 7 and 8 TeV, are combined, resulting in |f(LV)V(tb)| = 1.02 +/- 0.04 (meas.) +/- 0.02 (theo.). All combined measurements are consistent with their corresponding Standard Model predictions.