Dual Antiplatelet and Glycoprotein Inhibitors in Emergency PCI

Platelet inhibition remains the core pharmacotherapy component in patients under-going emergency or primary percutaneous coronary interventions (PCI). This can be achieved using a number of intravenous and oral preparations. Intravenous (iv) antiplatelets include various glycoprotein IIb/IIIa (GPIIb/IIIa) inhibitors and the only available intravenous P2Y12 inhibitor, cangrelor. Available oral agents include aspirin and various P2Y12 inhibitors or their analogues. These are usually used in combination with the intention to maintain dual antiplatelet therapy (DAPT) for a period of time (generally up to 12 months) after the index PCI procedure.Understanding and appropriate use of antiplatelet agents are vital in optimizing clinical outcomes of patients with acute coronary syndromes, particularly in the emergency setting where the patient may be naïve to all pharmacological agents. In this review, an overview on antiplatelet therapy for patient needing emergency PCI is described, including evidence from important clinical trials and suggested anti-platelet therapy regimens by published clinical practice guidelines

PRISM (Polarized Radiation Imaging and Spectroscopy Mission): A White Paper on the Ultimate Polarimetric Spectro-Imaging of the Microwave and Far-Infrared Sky

PRISM (Polarized Radiation Imaging and Spectroscopy Mission) was proposed to ESA in response to the Call for White Papers for the definition of the L2 and L3 Missions in the ESA Science Programme. PRISM would have two instruments: (1) an imager with a 3.5m mirror (cooled to 4K for high performance in the far-infrared---that is, in the Wien part of the CMB blackbody spectrum), and (2) an Fourier Transform Spectrometer (FTS) somewhat like the COBE FIRAS instrument but over three orders of magnitude more sensitive. Highlights of the new science (beyond the obvious target of B-modes from gravity waves generated during inflation) made possible by these two instruments working in tandem include: (1) the ultimate galaxy cluster survey gathering 10e6 clusters extending to large redshift and measuring their peculiar velocities and temperatures (through the kSZ effect and relativistic corrections to the classic y-distortion spectrum, respectively) (2) a detailed investigation into the nature of the cosmic infrared background (CIB) consisting of at present unresolved dusty high-z galaxies, where most of the star formation in the universe took place, (3) searching for distortions from the perfect CMB blackbody spectrum, which will probe a large number of otherwise inaccessible effects (e.g., energy release through decaying dark matter, the primordial power spectrum on very small scales where measurements today are impossible due to erasure from Silk damping and contamination from non-linear cascading of power from larger length scales). These are but a few of the highlights of the new science that will be made possible with PRISM.Comment: 20 pages Late

Effects of thermal inflation on small scale density perturbations

In cosmological scenarios with thermal inflation, extra eras of moduli matter domination, thermal inflation and flaton matter domination exist between primordial inflation and the radiation domination of Big Bang nucleosynthesis. During these eras, cosmological perturbations on small scales can enter and re-exit the horizon, modifying the power spectrum on those scales. The largest modified scale, k<inf>b</inf>, touches the horizon size when the expansion changes from deflation to inflation at the transition from moduli domination to thermal inflation. We analytically calculate the evolution of perturbations from moduli domination through thermal inflation and evaluate the curvature perturbation on the constant radiation density hypersurface at the end of thermal inflation to determine the late time curvature perturbation. Our resulting transfer function suppresses the power spectrum by a factor 0??? 5 at k 蠑 k<inf>b</inf>, with k<inf>b</inf> corresponding to anywhere from megaparsec to subparsec scales depending on the parameters of thermal inflation. Thus, thermal inflation might be constrained or detected by small scale observations such as CMB distortions or 21cm hydrogen line observations. © 2015 IOP Publishing Ltd and Sissa Medialab srlclose0

N-body lensed CMB maps: lensing extraction and characterization

We reconstruct shear maps and angular power spectra from simulated weakly lensed total intensity (TT) and polarised (EB) maps of the Cosmic Microwave Background (CMB) anisotropies, obtained using Born approximated ray-tracing through the N-body simulated Cold Dark Matter (CDM) structures in the Millennium Simulations (MS). We compare the recovered signal with the \u39bCDM prediction, on the whole interval of angular scales which is allowed by the finite box size, extending from the degree scale to the arcminute, by applying a quadratic estimator in the flat sky limit; we consider PRISM-like instrumental specification for future generation CMB satellites, corresponding to arcminute angular resolution of 3.2\u2032 and sensitivity of 2.43 \u3bcK-arcmin. The noise contribution in the simulations closely follows the estimator prediction, becoming dominated by limits in the angular resolution for the EB signal, at \u21131500. The recovered signal shows no visible departure from predictions of the weak lensing power within uncertainties, when considering TT and EB data singularly. In particular, the reconstruction precision reaches the level of a few percent in bins with \u394\u2113100 in the angular multiple interval 1000\u21132000 for T, and about 10% for EB. Within the adopted specifications, polarisation data do represent a significant contribution to the lensing shear, which appear to faithfully trace the underlying N-body structure down to the smallest angular scales achievable with the present setup, validating at the same time the latter with respect to semi-analytical predictions from \u39bCDM cosmology at the level of CMB lensing statistics. This work demonstrates the feasibility of CMB lensing studies based on large scale simulations of cosmological structure formation in the context of the current and future high resolution and sensitivity CMB experiment. \ua9 c 2014 IOP Publishing Ltd and Sissa Medialab srl