Chest Pain of Uncertain Aetiology: Role of Contrast Enhanced Computed Tomography in the Emergency Department

There is increasing role of computed tomographic (CT) in the assessment of acute chest pain in the emergency department especially when the diagnosis is not clear. We report a case where non ECG gated contrast enhanced CT in the emergency department for rule-out of pulmonary embolus guided to the actual diagnosis, which was, acute coronary event, as evidenced by the presence of perfusion defect

The Primordial Inflation Explorer (PIXIE): A Nulling Polarimeter for Cosmic Microwave Background Observations

The Primordial Inflation Explorer (PIXIE) is an Explorer-class mission to measure the gravity-wave signature of primordial inflation through its distinctive imprint on the linear polarization of the cosmic microwave background. The instrument consists of a polarizing Michelson interferometer configured as a nulling polarimeter to measure the difference spectrum between orthogonal linear polarizations from two co-aligned beams. Either input can view the sky or a temperature-controlled absolute reference blackbody calibrator. PIXIE will map the absolute intensity and linear polarization (Stokes I, Q, and U parameters) over the full sky in 400 spectral channels spanning 2.5 decades in frequency from 30 GHz to 6 THz (1 cm to 50 um wavelength). Multi-moded optics provide background-limited sensitivity using only 4 detectors, while the highly symmetric design and multiple signal modulations provide robust rejection of potential systematic errors. The principal science goal is the detection and characterization of linear polarization from an inflationary epoch in the early universe, with tensor-to-scalar ratio r < 10^{-3} at 5 standard deviations. The rich PIXIE data set will also constrain physical processes ranging from Big Bang cosmology to the nature of the first stars to physical conditions within the interstellar medium of the Galaxy.Comment: 37 pages including 17 figures. Submitted to the Journal of Cosmology and Astroparticle Physic

Interacting Kasner-type cosmologies

It is well known that Kasner-type cosmologies provide a useful framework for analyzing the three-dimensional anisotropic expansion because of the simplification of the anisotropic dynamics. In this paper relativistic multi-fluid Kasner-type scenarios are studied. We first consider the general case of a superposition of two ideal cosmic fluids, as well as the particular cases of non-interacting and interacting ones, by introducing a phenomenological coupling function $q(t)$. For two-fluid cosmological scenarios there exist only cosmological scaling solutions, while for three-fluid configurations there exist not only cosmological scaling ones, but also more general solutions. In the case of triply interacting cosmic fluids we can have energy transfer from two fluids to a third one, or energy transfer from one cosmic fluid to the other two. It is shown that by requiring the positivity of energy densities there always is a matter component which violates the dominant energy condition in this kind of anisotropic cosmological scenarios.Comment: Accepted for publication in Astrophysics &Space Science, 8 page

Scalar Field Dark Matter

This work is a review of the last results of research on the Scalar Field Dark Matter model of the Universe at cosmological and at galactic level. We present the complete solution to the scalar field cosmological scenario in which the dark matter is modeled by a scalar field $\Phi$ with the scalar potential $V(\Phi)=V_{0}(cosh {(\lambda \sqrt{\kappa_{0}}\Phi)}-1)$ and the dark energy is modeled by a scalar field $\Psi$, endowed with the scalar potential $\tilde{V}(\Psi)= \tilde{V_{0}}(\sinh{(\alpha \sqrt{\kappa_{0}}\Psi)})^{\beta}$, which together compose the 95% of the total matter energy in the Universe. The model presents successfully deals with the up to date cosmological observations, and is a good candidate to treat the dark matter problem at the galactic level.Comment: 11 pagez, 5 figures, REVTeX. To appear in proceedings of the ``Mexican Meeting on Exact Solutions and Scalar Fields in Gravity '', in honour of Heinz Dehnen's 65th Birthday and Dietrich Kramer's 60th Birthday. Mexico D.F., Mexico, in press. More info at http://www.fis.cinvestav.mx/~siddh/PHI

3 years of liraglutide versus placebo for type 2 diabetes risk reduction and weight management in individuals with prediabetes: a randomised, double-blind trial

Background: Liraglutide 3·0 mg was shown to reduce bodyweight and improve glucose metabolism after the 56-week period of this trial, one of four trials in the SCALE programme. In the 3-year assessment of the SCALE Obesity and Prediabetes trial we aimed to evaluate the proportion of individuals with prediabetes who were diagnosed with type 2 diabetes. Methods: In this randomised, double-blind, placebo-controlled trial, adults with prediabetes and a body-mass index of at least 30 kg/m2, or at least 27 kg/m2 with comorbidities, were randomised 2:1, using a telephone or web-based system, to once-daily subcutaneous liraglutide 3·0 mg or matched placebo, as an adjunct to a reduced-calorie diet and increased physical activity. Time to diabetes onset by 160 weeks was the primary outcome, evaluated in all randomised treated individuals with at least one post-baseline assessment. The trial was conducted at 191 clinical research sites in 27 countries and is registered with ClinicalTrials.gov, number NCT01272219. Findings: The study ran between June 1, 2011, and March 2, 2015. We randomly assigned 2254 patients to receive liraglutide (n=1505) or placebo (n=749). 1128 (50%) participants completed the study up to week 160, after withdrawal of 714 (47%) participants in the liraglutide group and 412 (55%) participants in the placebo group. By week 160, 26 (2%) of 1472 individuals in the liraglutide group versus 46 (6%) of 738 in the placebo group were diagnosed with diabetes while on treatment. The mean time from randomisation to diagnosis was 99 (SD 47) weeks for the 26 individuals in the liraglutide group versus 87 (47) weeks for the 46 individuals in the placebo group. Taking the different diagnosis frequencies between the treatment groups into account, the time to onset of diabetes over 160 weeks among all randomised individuals was 2·7 times longer with liraglutide than with placebo (95% CI 1·9 to 3·9, p&lt;0·0001), corresponding with a hazard ratio of 0·21 (95% CI 0·13–0·34). Liraglutide induced greater weight loss than placebo at week 160 (–6·1 [SD 7·3] vs −1·9% [6·3]; estimated treatment difference −4·3%, 95% CI −4·9 to −3·7, p&lt;0·0001). Serious adverse events were reported by 227 (15%) of 1501 randomised treated individuals in the liraglutide group versus 96 (13%) of 747 individuals in the placebo group. Interpretation: In this trial, we provide results for 3 years of treatment, with the limitation that withdrawn individuals were not followed up after discontinuation. Liraglutide 3·0 mg might provide health benefits in terms of reduced risk of diabetes in individuals with obesity and prediabetes. Funding: Novo Nordisk, Denmark

Track D Social Science, Human Rights and Political Science

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138414/1/jia218442.pd