Glycoprotein IIb/IIIa Inhibitors Use and Outcome after Percutaneous Coronary Intervention for Non-ST Elevation Myocardial Infarction

Aims. We investigate the effect of glycoprotein IIb/IIIa (GP IIb/IIIa) inhibitors on long-term outcomes following percutaneous coronary intervention (PCI) after non-ST elevation myocardial infarction (NSTEMI). Meta-analyses indicate that these agents are associated with improved short-term outcomes. However, many trials were undertaken before the routine use of P2Y12 inhibitors. Recent studies yield conflicting results and registry data have suggested that GP IIb/IIIa inhibitors may cause more bleeding than what trials indicate. Methods and Results. This retrospective observational study involves 3047 patients receiving dual-antiplatelet therapy who underwent PCI for NSTEMI. Primary outcome was all-cause mortality. Major adverse cardiac events (MACE) were a secondary outcome. Mean follow-up was 4.6 years. Patients treated with GP IIb/IIIa inhibitors were younger with fewer comorbidities. Although the unadjusted Kaplan-Meier analysis suggested that GP IIb/IIIa inhibitor use was associated with improved outcomes, multivariate analysis (including propensity scoring) showed no benefit for either survival (P=0.136) or MACE (P=0.614). GP IIb/IIIa inhibitor use was associated with an increased risk of major bleeding (P=0.021). Conclusion. Although GP IIb/IIIa inhibitor use appeared to improve outcomes after PCI for NSTEMI, patients who received GP IIb/IIIa inhibitors tended to be at lower risk. After multivariate adjustment we observed no improvement in MACE or survival and an increased risk of major bleeding

A Hot Uranus Orbiting the Super Metal-rich Star HD77338 and the Metallicity - Mass Connection

We announce the discovery of a low-mass planet orbiting the super metal-rich K0V star HD77338 as part of our on-going Calan-Hertfordshire Extrasolar Planet Search. The best fit planet solution has an orbital period of 5.7361\pm0.0015 days and with a radial velocity semi-amplitude of only 5.96\pm1.74 m/s, we find a minimum mass of 15.9+4.7-5.3 Me. The best fit eccentricity from this solution is 0.09+0.25-0.09, and we find agreement for this data set using a Bayesian analysis and a periodogram analysis. We measure a metallicity for the star of +0.35\pm0.06 dex, whereas another recent work (Trevisan et al. 2011) finds +0.47\pm0.05 dex. Thus HD77338b is one of the most metal-rich planet host stars known and the most metal-rich star hosting a sub-Neptune mass planet. We searched for a transit signature of HD77338b but none was detected. We also highlight an emerging trend where metallicity and mass seem to correlate at very low masses, a discovery that would be in agreement with the core accretion model of planet formation. The trend appears to show that for Neptune-mass planets and below, higher masses are preferred when the host star is more metal-rich. Also a lower boundary is apparent in the super metal-rich regime where there are no very low-mass planets yet discovered in comparison to the sub-solar metallicity regime. A Monte Carlo analysis shows that this, low-mass planet desert, is statistically significant with the current sample of 36 planets at around the 4.5\sigma\ level. In addition, results from Kepler strengthen the claim for this paucity of the lowest-mass planets in super metal-rich systems. Finally, this discovery adds to the growing population of low-mass planets around low-mass and metal-rich stars and shows that very low-mass planets can now be discovered with a relatively small number of data points using stable instrumentation.Comment: 25 pages, 15 figures, 5 tables, accepted for publication in Ap

Correspondence between geometrical and differential definitions of the sine and cosine functions and connection with kinematics

In classical physics, the familiar sine and cosine functions appear in two forms: (1) geometrical, in the treatment of vectors such as forces and velocities, and (2) differential, as solutions of oscillation and wave equations. These two forms correspond to two different definitions of trigonometric functions, one geometrical using right triangles and unit circles, and the other employing differential equations. Although the two definitions must be equivalent, this equivalence is not demonstrated in textbooks. In this manuscript, the equivalence between the geometrical and the differential definition is presented assuming no a priori knowledge of the properties of sine and cosine functions. We start with the usual length projections on the unit circle and use elementary geometry and elementary calculus to arrive to harmonic differential equations. This more general and abstract treatment not only reveals the equivalence of the two definitions but also provides an instructive perspective on circular and harmonic motion as studied in kinematics. This exercise can help develop an appreciation of abstract thinking in physics.Comment: 6 pages including 1 figur

S_3 and the L=1 Baryons in the Quark Model and the Chiral Quark Model

The S_3 symmetry corresponding to permuting the positions of the quarks within a baryon allows us to study the 70-plet of L=1 baryons without an explicit choice for the spatial part of the quark wave functions: given a set of operators with definite transformation properties under the spin-flavor group SU(3) x SU(2) and under this S_3, the masses of the baryons can be expressed in terms of a small number of unknown parameters which are fit to the observed L=1 baryon mass spectrum. This approach is applied to study both the quark model and chiral constituent quark model. The latter theory leads to a set of mass perturbations which more satisfactorily fits the observed L=1 baryon mass spectrum (though we can say nothing, within our approach, about the physical reasonableness of the parameters in the fit). Predictions for the mixing angles and the unobserved baryon masses are given for both models as well as a discussion of specific baryons.Comment: 24 pages, requires picte

Anti-tubulin drugs conjugated to anti-ErbB antibodies selectively radiosensitize.

Tumour resistance to radiotherapy remains a barrier to improving cancer patient outcomes. To overcome radioresistance, certain drugs have been found to sensitize cells to ionizing radiation (IR). In theory, more potent radiosensitizing drugs should increase tumour kill and improve patient outcomes. In practice, clinical utility of potent radiosensitizing drugs is curtailed by off-target side effects. Here we report potent anti-tubulin drugs conjugated to anti-ErbB antibodies selectively radiosensitize to tumours based on surface receptor expression. While two classes of potent anti-tubulins, auristatins and maytansinoids, indiscriminately radiosensitize tumour cells, conjugating these potent anti-tubulins to anti-ErbB antibodies restrict their radiosensitizing capacity. Of translational significance, we report that a clinically used maytansinoid ADC, ado-trastuzumab emtansine (T-DM1), with IR prolongs tumour control in target expressing HER2+ tumours but not target negative tumours. In contrast to ErbB signal inhibition, our findings establish an alternative therapeutic paradigm for ErbB-based radiosensitization using antibodies to restrict radiosensitizer delivery

Enhanced triage for patients with suspected cardiac chest pain: the History and Electrocardiogram-only Manchester Acute Coronary Syndromes decision aid.

OBJECTIVES: Several decision aids can 'rule in' and 'rule out' acute coronary syndromes (ACS) in the Emergency Department (ED) but all require measurement of blood biomarkers. A decision aid that does not require biomarker measurement could enhance risk stratification at triage and could be used in the prehospital environment. We aimed to derive and validate the History and ECG-only Manchester ACS (HE-MACS) decision aid using only the history, physical examination and ECG. METHODS: We undertook secondary analyses in three prospective diagnostic accuracy studies that included patients presenting to the ED with suspected cardiac chest pain. Clinicians recorded clinical features at the time of arrival using a bespoke form. Patients underwent serial troponin sampling and 30-day follow-up for the primary outcome of ACS. The model was derived by logistic regression in one cohort and validated in two similar prospective studies. RESULTS: The HE-MACS model was derived in 796 patients and validated in cohorts of 474 and 659 patients. HE-MACS incorporated age, sex, systolic blood pressure plus five historical variables to stratify patients into four risk groups. On validation, 5.5 and 12.1% (pooled total 9.4%) patients were identified as 'very low risk' (potential immediate rule out) with a pooled sensitivity of 99.5% (95% confidence interval: 97.1-100.0%). CONCLUSION: Using only the patient's history and ECG, HE-MACS could 'rule out' ACS in 9.4% of patients while effectively risk stratifying remaining patients. This is a very promising tool for triage in both the prehospital environment and ED. Its impact should be prospectively evaluated in those settings

Results from the First Science Run of the ZEPLIN-III Dark Matter Search Experiment

The ZEPLIN-III experiment in the Palmer Underground Laboratory at Boulby uses a 12kg two-phase xenon time projection chamber to search for the weakly interacting massive particles (WIMPs) that may account for the dark matter of our Galaxy. The detector measures both scintillation and ionisation produced by radiation interacting in the liquid to differentiate between the nuclear recoils expected from WIMPs and the electron recoil background signals down to ~10keV nuclear recoil energy. An analysis of 847kg.days of data acquired between February 27th 2008 and May 20th 2008 has excluded a WIMP-nucleon elastic scattering spin-independent cross-section above 8.1x10(-8)pb at 55GeV/c2 with a 90% confidence limit. It has also demonstrated that the two-phase xenon technique is capable of better discrimination between electron and nuclear recoils at low-energy than previously achieved by other xenon-based experiments.Comment: 12 pages, 17 figure

Airborne Radar Interferometric Repeat-Pass Processing

Earth science research often requires crustal deformation measurements at a variety of time scales, from seconds to decades. Although satellites have been used for repeat-track interferometric (RTI) synthetic-aperture-radar (SAR) mapping for close to 20 years, RTI is much more difficult to implement from an airborne platform owing to the irregular trajectory of the aircraft compared with microwave imaging radar wavelengths. Two basic requirements for robust airborne repeat-pass radar interferometry include the ability to fly the platform to a desired trajectory within a narrow tube and the ability to have the radar beam pointed in a desired direction to a fraction of a beam width. Uninhabited Aerial Vehicle Synthetic Aperture Radar (UAVSAR) is equipped with a precision auto pilot developed by NASA Dryden that allows the platform, a Gulfstream III, to nominally fly within a 5 m diameter tube and with an electronically scanned antenna to position the radar beam to a fraction of a beam width based on INU (inertial navigation unit) attitude angle measurements

Recent direct reaction experimental studies with radioactive tin beams

Direct reaction techniques are powerful tools to study the single-particle nature of nuclei. Performing direct reactions on short-lived nuclei requires radioactive ion beams produced either via fragmentation or the Isotope Separation OnLine (ISOL) method. Some of the most interesting regions to study with direct reactions are close to the magic numbers where changes in shell structure can be tracked. These changes can impact the final abundances of explosive nucleosynthesis. The structure of the chain of tin isotopes is strongly influenced by the Z=50 proton shell closure, as well as the neutron shell closures lying in the neutron-rich, N=82, and neutron-deficient, N=50, regions. Here we present two examples of direct reactions on exotic tin isotopes. The first uses a one-neutron transfer reaction and a low-energy reaccelerated ISOL beam to study states in 131Sn from across the N=82 shell closure. The second example utilizes a one-neutron knockout reaction on fragmentation beams of neutron-deficient 106,108Sn. In both cases, measurements of gamma rays in coincidence with charged particles proved to be invaluable.Comment: 11 pages, 5 figures, Zakopane Conference on Nuclear Physics "Extremes of the Nuclear Landscape", Zakopane, Poland, August 31 - September 7, 201