Implications of the antiplatelet therapy gap left with discontinuation of prasugrel in Canada

Background The current Canadian Cardiovascular Society antiplatelet therapy guidelines recommend the use of ticagrelor or prasugrel over clopidogrel as first-line platelet P2Y12 receptor antagonists for treatment of moderate- to high-risk acute coronary syndromes. Recently, Effient (prasugrel [Eli Lilly Canada Inc, Toronto, Canada]) was discontinued by its distributor in Canada. Methods Five members of the Canadian Cardiovascular Society antiplatelet therapy 2018 guidelines committee undertook an independent, evidence-based review to outline patients for whom prasugrel should be the optimal P2Y12 agent and discuss alternative strategies to consider without prasugrel. Results Several clinical scenarios where prasugrel should be indicated are identified and discussed. Considerations to be undertaken for alternative therapies are summarized, including a review of national and international guidelines for de-escalation of P2Y12 receptor antagonists. Conclusions The discontinuation of prasugrel poses a challenge for clinicians. Clinicians must consider key factors in determining the best alternate therapy.Introduction Dans ses lignes directrices actuelles sur la thérapie antiplaquettaire, la Société canadienne de cardiologie recommande l’utilisation du ticagrélor ou du prasugrel plutôt que l’utilisation du clopidogrel comme antagonistes des récepteurs plaquettaires P2Y12 de première intention dans le traitement des patients qui présentent un risque modéré à élevé de syndromes coronariens aigus. Depuis peu, le distributeur a cessé la distribution d’Effient (prasugrel) au Canada. Méthodes Cinq membres du comité des lignes directrices 2018 sur la thérapie antiplaquettaire de la Société canadienne de cardiologie ont entrepris une revue indépendante fondée sur les données probantes pour dresser le profil des patients pour lesquels le prasugrel devrait être la meilleure option parmi les antagonistes des récepteurs P2Y12 et se pencher sur les traitements alternatifs en l'absence de prasugrel. Résultats Plusieurs scénarios cliniques où le prasugrel devrait être indiqué sont recensés et abordés. Les réflexions sur les solutions de rechange au traitement, notamment une revue des lignes directrices nationales et internationales en matière de désescalade des antagonistes des récepteurs P2Y12, sont présentées. Conclusions La cessation de la distribution du prasugrel pose problème aux cliniciens. Les cliniciens doivent tenir compte des facteurs clés pour déterminer le meilleur traitement de remplacement

Lattice dynamics and structural stability of ordered Fe3Ni, Fe3Pd and Fe3Pt alloys

We investigate the binding surface along the Bain path and phonon dispersion relations for the cubic phase of the ferromagnetic binary alloys Fe3X (X = Ni, Pd, Pt) for L12 and DO22 ordered phases from first principles by means of density functional theory. The phonon dispersion relations exhibit a softening of the transverse acoustic mode at the M-point in the L12-phase in accordance with experiments for ordered Fe3Pt. This instability can be associated with a rotational movement of the Fe-atoms around the Ni-group element in the neighboring layers and is accompanied by an extensive reconstruction of the Fermi surface. In addition, we find an incomplete softening in [111] direction which is strongest for Fe3 Ni. We conclude that besides the valence electron density also the specific Fe-content and the masses of the alloying partners should be considered as parameters for the design of Fe-based functional magnetic materials.Comment: Revised version, accepted for publication in Physical Review

The PAndAS View of the Andromeda Satellite System. IV Global properties

We build a statistical framework to infer the global properties of the satellite system of the Andromeda galaxy (M31) from the properties of individual dwarf galaxies located in the Pan-Andromeda Archaelogical Survey (PAndAS) and the previously determined completeness of the survey. Using forward modeling, we infer the slope of the luminosity function of the satellite system, the slope of its spatial density distribution, and the size-luminosity relation followed by the dwarf galaxies. We find that the slope of the luminosity function is $\beta=-1.5\pm0.1$. Combined with the spatial density profile, it implies that, when accounting for survey incompleteness, M31 hosts $92_{-26}^{+19}$ dwarf galaxies with $M_\textrm{V}<-5.5$ and a sky-projected distance from M31 between 30 and 300kpc. We conclude that many faint or distant dwarf galaxies remain to be discovered around Andromeda, especially outside the PAndAS footprint. Finally, we use our model to test if the higher number of satellites situated in the hemisphere facing the Milky Way could be explained simply by the detection limits of dwarf galaxy searches. We rule this out at $>99.9\%$ confidence and conclude that this anisotropy is an intrinsic feature of the M31 satellite system. The statistical framework we present here is a powerful tool to robustly constrain the properties of a satellite system and compare those across hosts, especially considering the upcoming start of the Euclid or Rubin large photometric surveys that are expected to uncover a large number of dwarf galaxies in the Local Volume.Comment: Submitted to ApJ - 12 pages, 6 figures, 2 table

Ultrahigh Bandwidth Spin Noise Spectroscopy: Detection of Large g-Factor Fluctuations in Highly n-Doped GaAs

We advance all optical spin noise spectroscopy (SNS) in semiconductors to detection bandwidths of several hundred gigahertz by employing an ingenious scheme of pulse trains from ultrafast laser oscillators as an optical probe. The ultrafast SNS technique avoids the need for optical pumping and enables nearly perturbation free measurements of extremely short spin dephasing times. We employ the technique to highly n-doped bulk GaAs where magnetic field dependent measurements show unexpected large g-factor fluctuations. Calculations suggest that such large g-factor fluctuations do not necessarily result from extrinsic sample variations but are intrinsically present in every doped semiconductor due to the stochastic nature of the dopant distribution.Comment: 5 pages, 3 figure

Interplay between edge states and simple bulk defects in graphene nanoribbons

We study the interplay between the edge states and a single impurity in a zigzag graphene nanoribbon. We use tight-binding exact diagonalization techniques, as well as density functional theory calculations to obtain the eigenvalue spectrum, the eigenfunctions, as well the dependence of the local density of states (LDOS) on energy and position. We note that roughly half of the unperturbed eigenstates in the spectrum of the finite-size ribbon hybridize with the impurity state, and the corresponding eigenvalues are shifted with respect to their unperturbed values. The maximum shift and hybridization occur for a state whose energy is inverse proportional to the impurity potential; this energy is that of the impurity peak in the DOS spectrum. We find that the interference between the impurity and the edge gives rise to peculiar modifications of the LDOS of the nanoribbon, in particular to oscillations of the edge LDOS. These effects depend on the size of the system, and decay with the distance between the edge and the impurity.Comment: 10 pages, 15 figures, revtex

Ethnic diversity as a multilevel construct:the combined effects of dissimilarity, group diversity, and societal status on learning performance in work groups

The authors present a model of the multilevel effects of diversity on individual learning performance in work groups. For ethnically diverse work groups, the model predicts that group diversity elicits either positive or negative effects on individual learning performance, depending on whether a focal individual’s ethnic dissimilarity from other group members is high or low. By further considering the societal status of an individual’s ethnic origin within society (Anglo versus non-Anglo for our U.K. context), the authors hypothesize that the model’s predictions hold more strongly for non-Anglo group members than for Anglo group members. We test this model with data from 412 individuals working on a 24-week business simulation in 87 four- to seven-person groups with varying degrees of ethnic diversity. Two of the three hypotheses derived from the model received full support and one hypothesis received partial support. Implications for theory development, methods, and practice in applied group diversity research are discussed

Evolving Clustered Random Networks

We propose a Markov chain simulation method to generate simple connected random graphs with a specified degree sequence and level of clustering. The networks generated by our algorithm are random in all other respects and can thus serve as generic models for studying the impacts of degree distributions and clustering on dynamical processes as well as null models for detecting other structural properties in empirical networks

On the stability of 2 \sqrt{2} x 2 \sqrt{2} oxygen ordered superstructures in YBa2Cu3O6+x

We have compared the ground-state energy of several observed or proposed " 2 \sqrt{2} x 2 \sqrt{2} oxygen (O) ordered superstructures " (from now on HS), with those of "chain superstructures" (CS) (in which the O atoms of the basal plane are ordered in chains), for different compositions x in YBa2Cu3O6+x. The model Hamiltonian contains i) the Madelung energy, ii) a term linear in the difference between Cu and O hole occupancies which controls charge transfer, and iii) covalency effects based on known results for $t-J$ models in one and two dimensions. The optimum distribution of charge is determined minimizing the total energy, and depends on two parameters which are determined from known results for x=1 and x=0.5. We obtain that on the O lean side, only CS are stable, while for x=7/8, a HS with regularly spaced O vacancies added to the x=1 structure is more stable than the corresponding CS for the same x. We find that the detailed positions of the atoms in the structure, and long-range Coulomb interactions, are crucial for the electronic structure, the mechanism of charge transfer, the stability of the different phases, and the possibility of phase separation.Comment: 24 text pages, Latex, one fig. included as ps file, to be publisheb in Phys. Rev.

First principles study of the origin and nature of ferromagnetism in (Ga,Mn)As

The properties of diluted Ga$_{1-x}$Mn$_x$As are calculated for a wide range of Mn concentrations within the local spin density approximation of density functional theory. M\"ulliken population analyses and orbital-resolved densities of states show that the configuration of Mn in GaAs is compatible with either 3d$^5$ or 3d$^6$, however the occupation is not integer due to the large $p$-$d$ hybridization between the Mn $d$ states and the valence band of GaAs. The spin splitting of the conduction band of GaAs has a mean field-like linear variation with the Mn concentration and indicates ferromagnetic coupling with the Mn ions. In contrast the valence band is antiferromagnetically coupled with the Mn impurities and the spin splitting is not linearly dependent on the Mn concentration. This suggests that the mean field approximation breaks down in the case of Mn-doped GaAs and corrections due to multiple scattering must be considered. We calculate these corrections within a simple free electron model and find good agreement with our {\it ab initio} results if a large exchange constant ($N\beta=-4.5$eV) is assumed.Comment: 15 pages, 14 figure