The role of cardiovascular magnetic resonance imaging and computed tomography angiography in suspected non-ST-elevation myocardial infarction patients:Design and rationale of the CARdiovascular Magnetic rEsoNance imaging and computed Tomography Angiography (CARMENTA) trial

BackgroundAlthough high-sensitivity cardiac troponin (hs-cTn) substantially improves the early detection of myocardial injury, it lacks specificity for acute myocardial infarction (MI). In suspected non–ST-elevation MI, invasive coronary angiography (ICA) remains necessary to distinguish between acute MI and noncoronary myocardial disease (eg, myocarditis), unnecessarily subjecting the latter to ICA and associated complications. This trial investigates whether implementing cardiovascular magnetic resonance (CMR) or computed tomography angiography (CTA) early in the diagnostic process may help to differentiate between coronary and noncoronary myocardial disease, thereby preventing unnecessary ICA.Study DesignIn this prospective, single-center, randomized controlled clinical trial, 321 consecutive patients with acute chest pain, elevated hs-cTnT, and nondiagnostic electrocardiogram are randomized to 1 of 3 strategies: (1) CMR, or (2) CTA early in the diagnostic process, or (3) routine clinical management. In the 2 investigational arms of the study, results of CMR or CTA will guide further clinical management. It is expected that noncoronary myocardial disease is detected more frequently after early noninvasive imaging as compared with routine clinical management, and unnecessary ICA will be prevented. The primary end point is the total number of patients undergoing ICA during initial admission. Secondary end points are 30-day and 1-year clinical outcome (major adverse cardiac events and major procedure-related complications), time to final diagnosis, quality of life, and cost-effectiveness.ConclusionThe CARMENTA trial investigates whether implementing CTA or CMR early in the diagnostic process in suspected non–ST-elevation MI based on elevated hs-cTnT can prevent unnecessary ICA as compared with routine clinical management, with no detrimental effect on clinical outcome

Search for eccentric black hole coalescences during the third observing run of LIGO and Virgo

Despite the growing number of confident binary black hole coalescences observed through gravitational waves so far, the astrophysical origin of these binaries remains uncertain. Orbital eccentricity is one of the clearest tracers of binary formation channels. Identifying binary eccentricity, however, remains challenging due to the limited availability of gravitational waveforms that include effects of eccentricity. Here, we present observational results for a waveform-independent search sensitive to eccentric black hole coalescences, covering the third observing run (O3) of the LIGO and Virgo detectors. We identified no new high-significance candidates beyond those that were already identified with searches focusing on quasi-circular binaries. We determine the sensitivity of our search to high-mass (total mass M>70 M⊙) binaries covering eccentricities up to 0.3 at 15 Hz orbital frequency, and use this to compare model predictions to search results. Assuming all detections are indeed quasi-circular, for our fiducial population model, we place an upper limit for the merger rate density of high-mass binaries with eccentricities 0<e≤0.3 at 0.33 Gpc−3 yr−1 at 90\% confidence level

Ultralight vector dark matter search using data from the KAGRA O3GK run

Among the various candidates for dark matter (DM), ultralight vector DM can be probed by laser interferometric gravitational wave detectors through the measurement of oscillating length changes in the arm cavities. In this context, KAGRA has a unique feature due to differing compositions of its mirrors, enhancing the signal of vector DM in the length change in the auxiliary channels. Here we present the result of a search for U(1)B−L gauge boson DM using the KAGRA data from auxiliary length channels during the first joint observation run together with GEO600. By applying our search pipeline, which takes into account the stochastic nature of ultralight DM, upper bounds on the coupling strength between the U(1)B−L gauge boson and ordinary matter are obtained for a range of DM masses. While our constraints are less stringent than those derived from previous experiments, this study demonstrates the applicability of our method to the lower-mass vector DM search, which is made difficult in this measurement by the short observation time compared to the auto-correlation time scale of DM

Impact of lumbar syndesmophyte on bone health as assessed by bone density (BMD) and bone texture (TBS) in men with axial spondyloarthritis.

Patients with spondyloarthritis (SpA) have an elevated incidence of osteoporosis and are at increased risk of pathological vertebral fracture. Evaluation of bone density by dual energy X-ray absorptiometry (DXA) has its limits in fracture prediction, already known in this population. One hypothesis is that the presence of lumbar syndesmophyte could overestimate the spine bone mineral density (BMD). Trabecular bone score (TBS) is a new texture measurement correlated with bone microarchitecture. Previous studies have shown that TBS is mildly impacted by osteoarthritis and thus could be a predictor of fracture better than spine BMD. We aimed to evaluate a male population of SpA with BMD and TBS measurement and see the impact of lumbar syndesmophytes. Two cohorts of SpA male patients (Lausanne, Sofia) with SpA disease, clinical and bone parameters (femoral neck and total spine BMD+spine TBS) were merged. We compared BMD and TBS results regarding to the presence/absence of syndesmophytes. Our study concerned 51 men [29 with lumbar syndesmophytes (L1 to L4,≥1), 22 without], fulfilling the European Spondyloarthropathy Study Group (ESSG) and the Assessment of SpondyloArthritis international Society (ASAS) criteria. Mean age was 52.18 years old (no difference between the 2 groups) and mean body mass index (BMI) 27.47kg/m <sup>2</sup> (29.12±0.67 with and 25.30±0.81 without, P=0.0006). For the overall population mean BMD T-score at the spine was -0.55±1.54, mean BMD T-score at the femoral neck -1.20±0.95 and mean lumbar spine TBS was 1.26±0.13. Regarding to the presence or the absence of syndesmophytes, mean spine BMD T-score was -0.07±1.63 and -1.18±1.16 (P=0.009 and 0.250 before and after adjustment for BMI), mean femoral neck BMD T-score was -1.37±0.93 and -0.97±0.94 (P=0.14 and 0.03 before and after adjustment for BMI) and mean TBS was 1.21±0.12 and 1.33±0.11 (P=0.001 and 0.06 before and after adjustment for BMI) respectively for SpA men with and without syndesmophytes. Our results showed that SpA men with and without syndesmophytes have lower results compared to the normal population regarding hip BMD, spine TBS and spine BMD except for men with syndesmophytes who have a normal BMD spine T-score. These results suggest that TBS is not influenced by the syndesmophytes in opposite to spine BMD and could be measured in this population in addition to the neck BMD to assess the bone fragility