Reliability of the CARE rule and the HEART score to rule out an acute coronary syndrome in non-traumatic chest pain patients

In patients consulting in the Emergency Department for chest pain, a HEART score ≤ 3 has been shown to rule out an acute coronary syndrome (ACS) with a low risk of major adverse cardiac event (MACE) occurrence. A negative CARE rule (≤ 1) that stands for the first four elements of the HEART score may have similar rule-out reliability without troponin assay requirement. We aim to prospectively assess the performance of the CARE rule and of the HEART score to predict MACE in a chest pain population. Prospective two-center non-interventional study. Patients admitted to the ED for non-traumatic chest pain were included, and followed-up at 6 weeks. The main study endpoint was the 6-week rate of MACE (myocardial infarction, coronary angioplasty, coronary bypass, and sudden unexplained death). 641 patients were included, of whom 9.5% presented a MACE at 6 weeks. The CARE rule was negative for 31.2% of patients, and none presented a MACE during follow-up [0, 95% confidence interval: (0.0–1.9)]. The HEART score was ≤ 3 for 63.0% of patients, and none presented a MACE during follow-up [0% (0.0–0.9)]. With an incidence below 2% in the negative group, the CARE rule seemed able to safely rule out a MACE without any biological test for one-third of patients with chest pain and the HEART score for another third with a single troponin assay

The simulations of charged particle acceleration from gas target at 20 TW SOKOL-P laser with intensity of 5⋅1019 W/cm2

2D PIC code simulations have been performed for the optimization of gas jet target parameters to achieve a maximal energy and efficiency of charged particle acceleration in planned experiments at the 20 TW picosecond SOKOL-P laser. These calculations specify an opportunity to obtain energy up to Ee ∼ 200 MeV and efficiency ηe ∼ 10% for accelerated electrons and Ep ∼ 30 − 50 MeV and ηp ∼ 5% for accelerated protons in these experiments at laser intensity I ∼ 5 ⋅ 1019 W/cm2. They show the necessity of providing a formation of hydrogen jets with diameter ∼ 1mm, a gas molecule concentration ∼ 2 ⋅ 1019 cm−3 and steep density gradients ∼ 200 μm at the edge of the gas jet target for achieving these parameters of laser accelerated particle beams

Nonlinear kinetic modeling and simulations of Raman scattering in a two-dimensional geometry

In this paper, we present our nonlinear kinetic modeling of stimulated Raman scattering (SRS) by the means of envelope equations, whose coefficients have been derived using a mixture of perturbative and adiabatic calculations. First examples of the numerical resolution of these envelope equations in a two-dimensional homogeneous plasma are given, and the results are compared against those of particle-in-cell (PIC) simulations. These preliminary comparisons are encouraging since our envelope code provides threshold intensities consistent with those of PIC simulations while requiring computational resources reduced by 4 to 5 orders of magnitude compared to full-kinetic codes