3 research outputs found
Response to Neutrons and γ-rays of Two Liquid Scintillators
- Author
- Publication venue
- 'Chitkara University Publications'
- Publication date
- 26/02/2019
- Field of study
Get PDFUltimaGoldTM AB and OptiphaseTrisafe are two liquid scintillators made by Perkin Elmer and EG & G Company respectively. Both are commercially promoted as scintillation detectors for α and β particles. In this work, the responses to γ-rays and neutrons of UltimaGoldTM AB and OptiphaseTriSafe liquid scintillators, without and with reflector, have been measured aiming to use these scintillators as γ-rays and neutron detectors. Responses to γ-rays and neutrons were measured as pulse shape spectra in a multichannel analyzer. Scintillators were exposed to gamma rays produced by 137Cs, 54Mn, 22Na and 60Co sources. The response to neutrons was obtained with a 241AmBe neutron source that was measured to 25 and 50 cm from the scintillators. The pulse height spectra due to gamma rays are shifted to larger channels as the photon energy increases and these responses are different from the response due to neutrons. Thus, UltimaGoldTM AB and OptiphaseTrisafe can be used to detect γ-rays and neutrons
Rivaroxaban or aspirin for patent foramen ovale and embolic stroke of undetermined source: a prespecified subgroup analysis from the NAVIGATE ESUS trial
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- Publication date
- 01/01/2018
- Field of study
No full textBackground: Patent foramen ovale (PFO) is a contributor to embolic stroke of undetermined source (ESUS). Subgroup analyses from previous studies suggest that anticoagulation could reduce recurrent stroke compared with antiplatelet therapy. We hypothesised that anticoagulant treatment with rivaroxaban, an oral factor Xa inhibitor, would reduce the risk of recurrent ischaemic stroke compared with aspirin among patients with PFO enrolled in the NAVIGATE ESUS trial. Methods: NAVIGATE ESUS was a double-blinded, randomised, phase 3 trial done at 459 centres in 31 countries that assessed the efficacy and safety of rivaroxaban versus aspirin for secondary stroke prevention in patients with ESUS. For this prespecified subgroup analysis, cohorts with and without PFO were defined on the basis of transthoracic echocardiography (TTE) and transoesophageal echocardiography (TOE). The primary efficacy outcome was time to recurrent ischaemic stroke between treatment groups. The primary safety outcome was major bleeding, according to the criteria of the International Society of Thrombosis and Haemostasis. The primary analyses were based on the intention-to-treat population. Additionally, we did a systematic review and random-effects meta-analysis of studies in which patients with cryptogenic stroke and PFO were randomly assigned to receive anticoagulant or antiplatelet therapy. Findings: Between Dec 23, 2014, and Sept 20, 2017, 7213 participants were enrolled and assigned to receive rivaroxaban (n=3609) or aspirin (n=3604). Patients were followed up for a mean of 11 months because of early trial termination. PFO was reported as present in 534 (7·4%) patients on the basis of either TTE or TOE. Patients with PFO assigned to receive aspirin had a recurrent ischaemic stroke rate of 4·8 events per 100 person-years compared with 2·6 events per 100 person-years in those treated with rivaroxaban. Among patients with known PFO, there was insufficient evidence to support a difference in risk of recurrent ischaemic stroke between rivaroxaban and aspirin (hazard ratio [HR] 0·54; 95% CI 0·22–1·36), and the risk was similar for those without known PFO (1·06; 0·84–1·33; pinteraction=0·18). The risks of major bleeding with rivaroxaban versus aspirin were similar in patients with PFO detected (HR 2·05; 95% CI 0·51–8·18) and in those without PFO detected (HR 2·82; 95% CI 1·69–4·70; pinteraction=0·68). The random-effects meta-analysis combined data from NAVIGATE ESUS with data from two previous trials (PICSS and CLOSE) and yielded a summary odds ratio of 0·48 (95% CI 0·24–0·96; p=0·04) for ischaemic stroke in favour of anticoagulation, without evidence of heterogeneity. Interpretation: Among patients with ESUS who have PFO, anticoagulation might reduce the risk of recurrent stroke by about half, although substantial imprecision remains. Dedicated trials of anticoagulation versus antiplatelet therapy or PFO closure, or both, are warranted. Funding: Bayer and Janssen
Rivaroxaban or aspirin for patent foramen ovale and embolic stroke of undetermined source: a prespecified subgroup analysis from the NAVIGATE ESUS trial
- Author
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- A Ali
- A Amelia Pinto
- A Arauz
- A Bacellar
- A Balazs
- A Baranowska
- A Barulin
- A Beinlich
- A Belkin
- A Benjamin
- A Cavallini
- A Chakrabarti
- A Chamorro
- A Corlobe
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- A Czlonkowska
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- A Danese
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- Publication venue
- 'Elsevier BV'
- Publication date
- Field of study
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